The collaborative journey of

a place of refuge, hope and support.

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Ancora House is the shared vision of Cheshire and Wirral Partnership NHS Foundation Trust and the young people in their care.

This truly collaborative approach to design engaged the young people from Pine Lodge, Maple Ward, their family groups, clinicians, teachers, designers, builders, maintenance, IT, planners, architects, artists, landscapers, Trust senior management and many more.

In the beginning...

Cheshire and Wirral Partnership NHS Foundation Trust (CWP) was formed in 2002, achieving Foundation Trust status in June 2007. The Trust provides mental health, substance misuse, learning disability and community physical health services to a population of over a million people.

Services are provided in partnership with commissioners, local authorities, voluntary and independent organisations, people who use the services and their carers. The Trust also provides specialist services within Liverpool, Sefton, Bolton, Warrington, Halton and Trafford.

In March 2014 the project to build a new 26 bed Child and Adolescent Mental Health Services (CAMHS) facility began, with a possible Psychiatric Intensive Care Unit (PICU) facility to be added at a later date.

CWP is committed to providing health facilities which are:

Safe - there will be no avoidable injury or harm to people from their healthcare and an appropriate clean and safe environment will be provided for the delivery of services at all times.

Person Centred - Mutually beneficial partnerships between people who use services, their families and those delivering services which respect individual needs and values and demonstrate compassion and continuity.

Effective - The most appropriate treatments, interventions, support and services will be delivered from the highest quality accommodation.

Through Ancora House, CWP will deliver highly specialised, person centred, intensive evidence based treatment in a recovery focussed environment. It will be the anchor for developing innovative services for young people and their families to best meet their individual needs.

Anjan Mandara, CWP CAMHS Clinical Director

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The role of the joint venture partnership is to make the best use of the CWP estate to support high quality clinical services that meet the needs of the diverse communities that CWP serves. The aim is to improve efficiency and ensure that buildings are fully utilised and fit for purpose.

Villicare managed the procurement of the £14.4m CAMHS facility, providing CWP with significant cost and resource benefits that may not otherwise have been realised, including the provision of the PICU from the outset.

Villicare managed an OJEU compliant, commercially competitive process to test the market and drive best value from the supply chain. This has resulted in the establishment of a Project Team that fully understands and shares the common goals and values of Villicare and CWP whilst delivering excellent value for money.

Villicare appointed Gilling Dod as the project architect, Boex as Interior Designers and Eric Wright Construction as the build contractor of the new facility.

The role of Villicare

This project will provide a state of the art child and adolescent mental health service unit. It will address the national agenda to provide increased mental health care and support for young people and we anticipate that it will become a best-practice facility, benefitting from the latest green technologies. CWP is committed to reinvesting in our services to provide patients with the best possible experience and the new unit will be an excellent facility for young people and their families across England.

Tim Welch, Director of Finance, Cheshire and Wirral Partnership NHS Foundation Trust

The Trust’s values – the 6 Cs (Care, Compassion, Competence, Communication, Courage and Commitment) demonstrate the Trust’s emphasis on the quality of services for patients and carers and highlight the qualities that the Trust looks for in its staff. They define what it feels like to work and receive care from the Trust and they are applicable to everyone associated with the organisation, patients, people who use services, carers, staff, partners and contractors alike.

The 6 Cs embody a set of behaviours to enable cultural change and underpin the Trust’s drive towards continuous improvement that will ensure that individually and collectively we can be the best that we can be.

Following the successful Ancora House project, a seventh C has been identified - Collaboration

The project definitions used by everyone involved are:

Innovation: innovation is crucial to the continuing success of any organisation

Innovate: make changes in something established, especially by introducing new methods, ideas, or products

Partnership: the state or condition of being a partner; participation; association; joint interest

Collaborate: to work, one with another; to cooperate usually willingly, with a common goal.

Defining success...

Ca

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Competence

Cour

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Communica tion

CWP6Cs

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Com p assi

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Typical design...

And so began the journey of exploration. Gilling Dod produced an initial Design Response to the Brief during RIBA stage 1 which contained some interesting design principles.

The general approach to the building can be seen to resemble these early sketches.

Benchmarking the ‘norm’...

Villicare and the Trust carried out extensive reviews of the proposed designs.

The ‘norm’ in mental health design does not provide a solution that meets the needs of our young people.

So what does the ‘norm’ look like?

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Collaborative engagement

From the beginning of the project, CWP and Villicare developed and implemented an extensive process of consultation.

This included detailed discussions with primary and secondary support services within the Trust, external agencies, the school that provides education to the young people resident in the existing CAMHS unit, clinicians within the CAMHS service, and most importantly – the young people and Young Advisors who will make Ancora House their home for a short while.

This process of engagement has been key to the success of the project.

The key reasons for collaborative engagement process were:

To meet the Trust’s key success criteria identified as part of the Project Brief.

To ensure that everyone understood exactly how the service operated and how the young people thought the facilities could be improved.

To offer as much opportunity as possible for the young people to gain some level of engagement and enhancement from the project.

from spaghetti and doughCreative flow

To ensure Villicare delivered a facility that met the needs of CWP and the young people that will use it, Interior Designers Boex were engaged to align the design brief with the vision.

Before commencing any design work a series of innovative design workshops were held to capture the views, aspirations, needs and safety requirements of the young people and CWP staff from the existing wards.

To “break the ice” and give the young people confidence that they can design and construct out came the spaghetti and Play-Doh!

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Collaborative engagement

Once the ice had been broken and some people stopped trying to blame their shortcomings in engineering practice on a faulty batch of spaghetti - the young people explored what was good and what could be better intheir current facilities of Maple Ward and Pine Lodge.

The Play-Doh came out again (whilst the spaghetti was sent away for testing!) and models of day spaces, bedrooms, and therapyrooms were created.

and detailed analysis...

This is an important project for both Villicare and for the young people that will use the facility. The Team has shown real enthusiasm to design a facility that will provide a therapeutic, healing, and nurturing environment that is affordable for the Trust to both build and operate. Villicare has been established to assist the Trust in achieving optimum benefits from capital investments such as the Tier 4 CAMHS project, and to challenge conventional design and construction practices.

Chris Tonge, General Manager of Villicare

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Naming and framing

‘Ancora’ a Latin noun meaning hope, refuge and support is the name for the new facility and was chosen by the young people who will make use of its services.

Graffiti artist Kieron showed the young people spray paint techniques and together they created a mural on the hording surrounding the building site and framing the new facility.

Developing artwork for Ancora House didn’t stop at the hoarding.

The young people have been introduced to ‘the arts’ internally and externally at every opportunity.

Artistic freedom...

The young people have been involved in the interior design, artwork to feature in key spaces, external landscaping, external colour schemes and even supported the design of the Ancora House logo.

This will help to deliver a truly person centred, therapeutic environment.To raise awareness of the new facility, the young people designed, created and produced a video.

You can view the video on YouTube: https://youtu.be/0xBhVw0ugS8

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Takeover day

The Takeover Challenge is an extension of Takeover Day, an annual event run by the Children’s Commissioner for England where organisations host young people to ‘take over’ staff roles for the day.

CWP held a full day of events, involving young people from Maple Ward, Bowmere Hospital and Pine Lodge who donned hard hats and hi-vis jackets for a full site tour. Leading the tour was Dan Allmark, Head of Capital and Property Management at CWP, Chris Tonge, Villicare LLP General Manager and Steve van den Hoek, Project Manager from Eric Wright Construction.

CAMHS staff and young people then got together to share their best practice in involvement and participation, before grilling a panel of senior CWP leaders about their plans for the future of CAMHS services. The panel included Sheena Cumiskey, Chief Executive, Andy Styring, Director of Operations and Liz Matthews, Associate Director of Patient and Carer Experience.

Takeover challenge

Young people involved on the day were left inspired by the events, and commented,

“The Takeover Challenge was a really fascinating day and taught me lots of new skills.”

“It was interesting to see what happens on a building site and I found out about lots of new careers. It was a productive day that captured me.”

“It was great to do something completely new. It was also interesting seeing how much the new build has come on since first being involved and to see that the designers and everyone has listened to what we have had to say.”

The day is fun and enlightening and certainly brings the views of different generations together to get a better rounded perspective on things. The Takeover Challenge gives young people the chance to work with adults, to experience the world of work and make their voices heard, while we adults gain a fresh perspective on what we do and how we do it.

Sheena Cumiskey, Chief Executive of CWP

It was great to see the level of interest and interaction from all of those involved in the Takeover Day. I think that we got as much out of the day as the young people who came to site. There is a great commitment from the Trust, Villicare, and wider Project Team to engage as much as possible with the young people from the CAMHS service – it is, after all, their building!

Chris Tonge, General Manager of Villicare

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An innovative solution

Following what was quite a challenging process of design development, the Trust were satisfied that Villicare and the design team had met the criteria set out by the young people in the workshops.

The young people identified the need for an area that worked equally well when they used it as one large group, in small clusters, or when just having some time alone.

The design process identified the benefits of different types of seating and at different heights to facilitate a sense of individuality and personal space.

The final design provides a flexible seating area with discrete separation from the corridor, whilst maintaining a sense of openness.

The original design principles upheld, the ‘norm’ has now well and truly been replaced by the innovative.

Improving interaction

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Private space

Bella Cope, a young advisor who has previously accessed services, describes the bedrooms in the new unit as “light with lots of storage space”.

Bella added that bedrooms within mental health facilities she has stayed at previously have felt “dark and claustrophobic”.

Mood lighting

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Building an identity

Coral will be the new 14 bed acute assessment ward for young people with mental health problems and high risk behaviour who can be admitted 24 hours a day, 7 days a week. It was previously known as Maple Ward at Bowmere Hospital.

Indigo will be the new 12 bed inpatient unit to replace Pine Lodge and specialises in intensive planned treatment packages for young people with the most severe and complex mental health problems including those with eating disorders.

Ancora House school provides an on-site short stay education facility where we can work with young people to develop a personalised learning plan to support their progress.

Previously based at Pine Lodge the school has been rated as ‘Outstanding’ by Ofsted.

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Studies have shown the benefits of horticultural therapy in assisting with a person’s general wellbeing and healing process.

Ancora House provides its young people with an opportunity to learn about growing plants, herbs, and vegetables and take responsibility for their own raised bed in the Horticultural Therapy Area.

They can even cook and share their produce with others in the kitchen. There is a dedicated chicken garden within the Horticultural Therapy area where you can sit amongst the plants and watch, feed, or care for the chickens.

Perhaps the signature dish of future Ancora House chefs will be vegetable omelette!

Each ward has its own safe outdoor areas reflecting the ward design and layout. One is for informal seating,

relaxing, or therapy sessions, and the other for recreation and fun, including giant sit-on chalkboards, built in sun loungers, and even the odd Teletubbies hill!

External design

Similar to the interior design solutions, traditional landscaping solutions for mental health facilities are not particularly focused on the needs of young people. The space surrounding Ancora House provided an opportunity to further develop the design input of the young people.

There will be secure gardens with horticultural and landscaped areas providing recreational facilities including outdoor exercise equipment.

The young people have been involved in planting apple trees and establishing the ‘wetlands’ with reeds, rushes and lily pads. Wild flower seeds were sown in the open grasslands areas to provide a natural habitat for the local flora and fauna.

The entire area will compliment the nearby Country Park and provide an opportunity in the future to observe

wildlife and perhaps provide study matter for science lessons delivered in Ancora House School.

Therapeutic gardens

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Local artist Stephen Broadbent was tasked with designing an artwork that could be enjoyed by everyone at Ancora House.

Understanding that Ancora House for many is a shelter, Stephen was struck by the idea of designing a shelter - a protective space.

The image that sprung to mind was that of a mother bird sheltering her young under her wing.

So he came up with the idea of a shape inspired by a bird’s wing.

Around 2m high, this scultural shape will allow young people to find their own way of using it. They can sit or lean inside it and the bird wing envelopes them.

Refuge, hope, support Moving forward...

The vision for Ancora House continues to develop and grow. The next stage will see innovative IT systems and equipment installed as part of the Villicare development programme for the Trust’s IT service.

This will include giant touch screens in wards, allowing young people to share photos and video, play therapeutic games and produce digital art. An Ancora ‘App’ is in

development that can be used by young people before, during and after their time at Ancora House.

Our legacy will ensure other young people have similar opportunities

Villicare has made a commitment to support Ancora House into the future. A legacy fund will be established to allow young people using the service to have the same level of opportunity

and experience as those young people involved in the development of Ancora House.

The fund will be used to support art led engagement activities such as graffiti workshops and design sessions, as well as horticultural and animal encounters that help in their recovery process.

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Ancora House

Ancora House will be a Tier 4 service, providing inpatient and day patient care for children and young people with severe and/or complex mental health conditions. It will provide 26 beds plus four PICU beds with day spaces, a central nursing station, an educational centre, visiting areas, and communal spaces. There will also be secure gardens with horticultural and landscaped areas providing recreational facilities including outdoor exercise equipment.Ancora House will provide CAMHS inpatient and day patient services across Cheshire, Wirral and Merseyside. Those accessing the services have been instrumental to the project, taking part in workshops designing their ideal spaces.

Avril Devaney MBE, Director of Nursing, Therapies and Patient Partnership said,

“Ancora House will play a huge part in our local health community, providing mental health services for young people across the region.”

Our team

Ancora House is a credit to the commitment of everyone involved in the project, but in particular to the Trust for their courage in daring to be different, and to the young people who have been so enthusiastic in helping and guiding us. This shows the real success that we can achieve when we Engage, Collaborate, and Innovate.”

Chris Tonge, General Manager of Villicare

Ancora House is a product of the efforts put in by young people through participation in developing services and CWP welcomes ongoing feedback from young people, families and their carers.

Anjan Mandara, CWP CAMHS Clinical Director

As a young person who has experienced the need for inpatient care, I can see how much better Ancora House meets the needs of those young people with mental health issues. In my opinion having a positive environment to recover in is crucial and can ease the difficulty of being away from home at such a challenging time in your life.

Bella Cope, CWP Young Advisor

Formed in November 2013, Villicare LLP is the joint venture company for the Strategic Estates Partnership (SEP) between Cheshire and Wirral Partnership NHS Foundation Trust and Ryhurst Limited.

The 15 year partnership enables improved estate and property management services, new and refurbished facilities and estate rationalisation through land acquisition, disposal and development.

The Villicare Board is formed from the senior executives of both partners. The Board members are Tim Welch, Director of Finance and Mike Maier, Chairman of CWP with Stephen Collinson, Managing Director and Aileen Ivanec, Group Legal Director of Ryhurst Limited.

The Trust is represented by their Informed Client (IC), Daniel Allmark, Head of Capital and Property Management who provides the daily contact between the Trust and Villicare General Manager, Chris Tonge.

Latin; overseer of estate or public property