Moor’s the merrier

“It’s luxury, pure luxury. It’s not even a prison and they even have a huge plasma screen,” insists the cab driver as we drive into the grounds of Broadmoor hospital in Berkshire.

“I read it in one of those tabloids, but everyone round here knows they are living in luxury. Prison is too easy in this country. You’ll see it for yourself soon. Did you know that the Yorkshire Ripper is in there?” I thank him and pay my fare.

Well, the driver was right about one thing: Broadmoor isn’t a prison. It’s actually a high-security hospital that provides round-the-clock care for patients with a mental disorder in a secure environment.

For the record there is no whopping great big plasma screen, it’s actually a projector. And as for the notion that Broadmoor is a place of luxury, well that really does depend on whether your idea of luxury is being locked up 24/7.

The truth is that Broadmoor is bound to spark debate, both on larger issues, such as whether justice is served by putting some of the country’s most notorious criminals (like Peter Sutcliffe, aka the Yorkshire Ripper) in a hospital, and on more particular issues, like the way the West London Mental Health NHS Trust runs it.

In 2003, the Commission for Healthcare Audit and Inspection (now the Healthcare Commission) launched a damning attack on the prison, accusing it of failing to meet even basic standards and calling a large number of wards “unfit for purpose”.

It branded the buildings as poorly configured and decorated, and lacking in basic standards of dignity, privacy, cleanliness and amenities. Improvements had to be made.

So the trust got busy. Last month it officially opened the £23m Paddock Centre, a purpose-built facility for 70 violent and sexual offenders. The unit is for those with dangerous and severe personality disorders (DSPD) and is part of a wider government programme to develop and pilot new mental health services for those who come under this category.

Oxford Architects and contractors Costain were charged with designing and constructing a building that would not only help address the criticisms of the past, but also match the high security demands Broadmoor carried.

David Phillips, capital projects manager for the trust, believes the biggest challenge was balancing the physical security and robustness needs against a reasonably looking end product.

He says the contractors and designers also had to bear in mind that: “We are a healthcare establishment, we are not there purely to contain.”

Work behind bars

Building in such a secure environment proved to be tough for Costain. Project manager Gareth Williams admits it was a hard programme to coordinate. Even before work began, staff were subjected to police and medical checks.

On site, cameras and mobile phones were forbidden, skills cards needed to be carried at all times and the contractors had to erect the building in a sealed space, fenced off from nearby patients and staff.

Costain was not allowed to store materials or containers within eight meters of the security fence. This led to extraordinary space-saving measures. Plant had to immobilised or moved when not in use. Total clearance was required at the end of every working day.

A logistics manager ensured vehicles followed an agreed route. Noise, dust and road cleanliness were regularly monitored and there was even a review to assess what impact the construction work could have on the safety and security of the existing centre.

“It’s fair to say that the hospital had their own team assisting us, telling us what we should and shouldn’t do,” Williams says. “So they were very effective in helping us manage our works. We weren’t allowed to bend the rules. If they said we could or couldn’t do something we couldn’t argue – that was the decision.”

His team worked long hours to adhere to the rules. It appears to have paid off. There were no major incidents and last year they scooped a silver medal at the Considerate Constructors Scheme Awards.

He was also unfazed about working in an environment that contained some of the country’s most infamous offenders. Surely that must give you the creeps?

“It was just like any other project really, we did not feel daunted by it. We had to comply with procedures and there was a lot more administration, but we never felt threatened,” says Williams.

Peter Norman, a partner at Oxford Architects, says they wanted to create a place that was “not threatening, a place where people can heal and be cared for”.

The main priorities for the trust were safety and security and the welfare of patients and staff. On the design front, Norman says the considerations were vast. From attempting to understand the type of patient that would be housed in the unit, to deciding what type of robust materials (to prevent attacks or self harm) would be used for the interiors.

The building had to give patients a quality of life and move away from the feeling of “containment” that had plagued Broadmoor’s reputation in the past. Previously, living space for patients was a lot more cramped, with low ceilings, less light and restricted views.

We weren’t allowed to bend the rules. If they said we could or couldn’t do something, we couldn’t argue

Gareth williams

The three-storey, 10,000m2 building is now located on the 53-acre site in Crowthorne. The chosen location was sloping and lumpy – something Costain had to put right – but it did offer a fantastic view, something the client felt would enhance treatment and assist with recovery.

Rooms with a view

Norman says: “We didn’t want people to feel enclosed and most of the bedrooms have views over the countryside.”

“They are patients and there is a clear definition here, while it is secure, they are not prisoners, they are patients. They are in there for treatment,” Williams says.

What the trust got was a strong building. It has a substructure of reinforced concrete foundations, sheet piling and basements with reinforced concrete substructure walls. The superstructure has load-bearing masonry and reinforced concrete with steel frame and precast and the externals are finished in masonry and with some vertical cladding.

The unit has six wards and facilities include a sports hall, bedrooms, day rooms, classrooms, therapy rooms, a large central forum for presentations and performances, and an enclosed courtyard.

It’s hard not to think of Broadmoor as a prison, but the new design helps. There are no bars on the doors and windows. Patients can open the windows and the building is light, airy and naturally ventilated. It also breaks away from conventional ward design and introduces open plan areas.

“What we wanted to avoid was a row of bedrooms off a corridor, which is a commonly used layout for prisons. Here, beds open to a communal space,” says Norman.

Ceilings are high throughout the centre and corridors are wide to ensure patients can be escorted around the building along clear sight lines.

The bedrooms are designed to keep patients safe and secure. Doors open outwards to prevent them blockading themselves in. Discreet buttons control showers and toilets – flush handles or pull-string light switches could be used as weapons or for self-harming.

Even before the centre was fitted out, Costain built a prototype bedroom that was subjected to a vigorous workout to ensure the specialist dense materials such as Trespa were suitable for furniture.

The finishes, according to Williams, are extremely robust. He says: “In all the patient areas you would struggle to break out. You can’t smash a hole through the building.” Patients cannot even scratch the walls or peel back the floor.

The end results are pretty impressive and this was largely due to the good relationships between the trust, contractors and architects. Client David Phillips says the working relationship ensured all disputes were resolved amicably. The trust, he says, doesn’t “rant and rave” and avoids apportioning blame.

He says: “If you don’t have good relationships you won’t deliver a good project.”

Group therapy

“If we had a problem or they (Costain) had a problem, it was put on the table and between us we resolved it. There were no hidden issues going on, even if somebody making a mistake caused that problem, and that happened.

“I think once the contractor can see that you are genuinely interested in working as a team, they are more willing to be open and more likely to deliver a successful product.”

He insists the trust is not a “nightmare” client and avoids changing its mind too often. “Anything we did want to change was in full consultation with Costain and only included if they felt it could be achieved,” he adds.

For those wanting to work with the trust in the future there appears to be plenty of work ahead. In November it was given the go-ahead to plan and organise a redevelopment programme that will cost just under £200m.

The modernisation programme for Broadmoor will include building new wards, central services and office accommodation. Laing O’Rourke has already clinched the ProCure 21 contract for cost and design consultancy work.

But for those wanting a slice of the action what will contractors need to demonstrate? Phillips knows the answer straightaway. “Openness. If you haven’t got openness then you don’t know what you’ve got.”