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SPEED (Supporting Psychiatry Experience and Education in District-Hospitals), a Pilot Program for Foundation Doctors
- Sam Fraser, Sophie Clark
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- Journal:
- BJPsych Open / Volume 10 / Issue S1 / June 2024
- Published online by Cambridge University Press:
- 01 August 2024, p. S103
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Aims
This pilot program aimed to enhance the psychiatry experience for foundation doctors (FYs) working at Ayr Hospital by identifying perceived areas where psychiatric support would benefit training, development or education. Subsequently strategies were aimed to be implemented by the psychiatry liaison service to enrich FYs' experience during their medical and surgical rotations. Feedback was aimed to be obtained to determine if the program would have value to other district hospitals and grades of junior doctors.
MethodsUnstructured interviews with 4 FYs were conducted in October 2023 to explore the current experience of psychiatry in medical or surgical placements at Ayr Hospital. Identified themes included barriers to completing supervised learning events (SLEs) for mental health cases (a requirement of the 2021 Foundation Curriculum), limited exposure to psychiatry teaching opportunities, and obstacles to pursuing development of interest in psychiatry (such as time to shadow psychiatry, or discuss career prospects in psychiatry).
A pilot program was initiated in November 2023 to improve the experience and education of psychiatry for FYs. This involved:
• Providing dedicated time on wards for FYs to complete SLEs with a member of the liaison service.
• Providing time for FYs to shadow the role of liaison psychiatry.
• Providing additional teaching tutorials, focused on topics chosen by FYs.
• Providing the opportunity to discuss and develop interest in psychiatry.
A survey to obtain both quantitative and qualitative feedback was sent to each FY that engaged in the program.
Results17 FYs engaged in the pilot program, with 13 providing feedback. All respondents felt the program increased their knowledge and confidence in approaching cases with a psychiatry element. They also all found the experience positive and a productive use of time. All deemed the program would be useful for other foundation trainees in medical hospitals. Free text feedback highlighted the program's value in facilitating case discussions, removing obstacles in completing mental health SLEs, providing useful relevant tutorials and providing opportunity to discuss further interest of psychiatry.
ConclusionThe pilot program successfully achieved its aim to improve FYs' experience of psychiatry. Although not measured in the survey, the program also appeared to foster positive relationships between the liaison service and junior medical staff. It also helped identify new appropriate referrals for the liaison service. An expansion of the program is planned to other district hospitals in Ayrshire and Arran, including consideration of expanding the participation to wider members of the junior doctor cohort.
The alarms should no longer be ignored: survey of the demand, capacity and provision of adult community eating disorder services in England and Scotland before COVID-19
- David Viljoen, Emily King, Sophie Harris, Jonathan Hollyman, Kate Costello, Eimear Galvin, Melissa Stock, Ulrike Schmidt, James Downs, Murali Sekar, Ciaran Newell, Sam Clark-Stone, Amy Wicksteed, Caroline Foster, Francesca Battisti, Laura Williams, Roshan Jones, Sarah Beglin, Stephen Anderson, Thuthirna Jebarsan, Viviane Ghuys, Agnes Ayton
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- Journal:
- BJPsych Bulletin , FirstView
- Published online by Cambridge University Press:
- 01 August 2023, pp. 1-9
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Aims/method
This national pre-pandemic survey compared demand and capacity of adult community eating disorder services (ACEDS) with NHS England (NHSE) commissioning guidance.
ResultsThirteen services in England and Scotland responded (covering 10.7 million population). Between 2016–2017 and 2019–2020 mean referral rates increased by 18.8%, from 378 to 449/million population. Only 3.7% of referrals were from child and adolescent eating disorder services (CEDS-CYP), but 46% of patients were aged 18–25 and 54% were aged >25. Most ACEDS had waiting lists and rationed access. Many could not provide full medical monitoring, adapt treatment for comorbidities, offer assertive outreach or provide seamless transitions. For patient volume, the ACEDS workforce budget was 15%, compared with the NHSE workforce calculator recommendations for CEDS-CYP. Parity required £7 million investment/million population for the ACEDS.
Clinical implicationsThis study highlights the severe pressure in ACEDS, which has increased since the COVID-19 pandemic. Substantial investment is required to ensure NHS ACEDS meet national guidance, offer evidence-based treatment, reduce risk and preventable deaths, and achieve parity with CEDS-CYP.
NHS Ayrshire and Arran Sustainability and Well-being Committee - Assessing and Improving Trainee Well-being
- Sam Fraser, Megan Barrett, Sophie Clark, Racheal Pulley
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S90
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Aims
To promote the Royal College's core principles of sustainable psychiatry, Junior Doctors at Ayrshire Central Hospital formed the Sustainability and Well-being Committee. The principle aim through 2022, following the COVID-19 pandemic, was to maximise junior well-being - knowing a sustainable workforce is one that feels supported and fulfilled by work and working conditions.
MethodsThrough meetings with junior doctors, qualitative information on factors impacting well-being in the work place was gathered, and three targets for improvement were identified.
The following domains and interventions were implemented:
1. Improve working environment: The doctor's office was sized for 2 staff maximum - despite staffing levels consistently in excess of 20 junior doctors. Additionally, there was no natural light. We obtained a new significantly larger office space, with natural light.
2. Comfort break area – Doctors identified that having an area with comfort seating to take breaks and socialise away from patients and visitors would be beneficial. We obtained a seating area and a coffee machine, maintained by the junior doctors.
3. Access technology – Absence of desktops and IT issues with older laptops was impairing productivity and morale. We obtained 4 new desktop computers, and personal laptops for core trainees.
A digital questionnaire was used to collect quantitative data retrospectively, from doctors currently working in the department, or who had done so in the last 6 months.
Likert scales were used to assess pre and post-intervention levels of well-being, and ranking intervention impact on this. Doctors also identified future areas of intervention going forward into 2023.
ResultsA total of 16 responses were obtained, and 100% of these agreed that feeling supported and good working conditions was important to maintaining wellness and productivity. Pre-intervention average wellness was rated 5.2 (with 1 being extremely poor, and 10 being extremely good), this increased to 8.1 post-intervention. Improved working environment had the most significant impact on well-being.
Respondents identified environmental sustainability as target for improvement in 2023, potentially through improved recycling, reducing meat consumption and car sharing. Further well-being interventions e.g., walks, promotion of Balint group and social events were also suggested.
ConclusionInterventions from the trainee-led Sustainability and Well-being Committee through 2022 improved working environment and subjective well-being. This demonstrates that junior staff can successfully initiate and lead projects to promote and improve sustainability in psychiatry. Results indicate that junior staff are willing to actively participate in interventions to improve well-being, and environmental sustainability in 2023.
3 - Baby boomers
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 29-52
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Summary
Synopsis
This research story reflects on the situated experiences, attitudes and opinions of one UK ‘baby boomer’ couple; referred to here as Matthew and Eileen, or the Cees. The informants are also my parents. In some respects, therefore, this is an autobiographical or ‘close’ account, since we once shared a home context, as well as formative life experiences. We have also sustained positive relationships into adult life. Furthermore, the dialogues that are examined here refer to family relations, including my siblings, grandparents, aunts and uncles, as well as family friends. While the research draws upon a deep and part situated relationship with the informants, the ‘story’ focuses on two research-framed events: a semi-structured interview in the informants’ home, and a guided tour or walking interview conducted in a local Pink & Knight development. The resulting data – clean verbatim transcript and field notes – were cross-examined in relation to a desktop contextual review and literature review undertaken at the time. In these terms, the individual story of my parents and their retirement lifestyle is situated within a wider cultural and theoretical context. The story recounts two recent property purchases, in Northern Ireland and England, and reflects on the couple’s preparedness for retirement living over the longer term. The Cees do not envisage moving for at least another ten years, and – not untypically – the idea of moving into retirement housing has not featured in their thinking.
Methods
The interview took place on 27 December 2014, following a busy Christmas spent in the Cees’ new Sussex home; a festive period that was considered to have ‘put the house to the test’ by three generations of family members. The interview was conducted in the kitchen-diner, and while conversational in nature, was structured around six questions:
• What does retirement mean to you?
• What do you think ‘old age’ means?
• What does home mean to you?
• What might motivate you to move?
• What are your impressions of housing options for older people?
• What does ‘retirement housing’ mean to you?
I also referred to visual material including promotional literature, architectural drawings and computer-generated images relating to Pink & Knight’s Avon Villa, as well as my photographs of the same. These were used to elicit first impressions and feedback on a retirement-living product and setting that were unfamiliar to the Cees.
Inside Retirement Housing
- Designing, Developing and Sustaining Later Lifestyles
- Sam Clark
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- Published by:
- Bristol University Press
- Published online:
- 20 June 2023
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- 11 November 2022
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Through stories and visual vignettes, it presents a range of stakeholders involved in the design, construction, management and habitation of third-age housing in the UK, highlighting the importance of design decisions for the everyday lives of older people.
5 - Villa context
- Sam Clark, Cardiff University
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- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 79-87
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Summary
Part II of this book centres on three key actors – property developer, resident owner and scheme manager – associated with the private sector retirementliving housing product known here as the retirement villa. The villa concept was developed by Pink & Knight and comprises of an age-exclusive housing block made up of privately owned one-and two-bedroom apartments grouped around communal facilities and services. A typical villa development consists of 40 apartments in one building, with the following features:
• concierge reception (staffed by a scheme manager);
• shared lounge, coffee bar and accessible toilet;
• guest suite (for use by friends and family);
• intruder alarm and CCTV entry system;
• a central lift serving all floors;
• 24-hour care and support system;
• landscaped gardens (including patio/ terrace associate with shared lounge);
• free parking (including electric vehicles, cycles and mobility scooters).
All villas are managed by an independent company, referred to here as Villa Management Services (VMS), which is owned by Pink & Knight. The management company collects the monthly service charge and is responsible for all maintenance, servicing and ongoing management of the villas. This accommodation model has developed over decades and is now becoming more widely recognised as a ‘lifestyle’ offer. For the avoidance of doubt, Pink & Knight’s product is not a designed care environment, nor are staff trained care workers. Some resident owners make private arrangements for care when they need it, but the villa is otherwise a domestic environment.
Another important aspect to note is the relatively small market segment which this product serves. According to Knight Frank (2018) there are 725,000 retirement housing units across the UK, which accounts for around 2.6 per cent of all homes across the UK. Of these, private retirement housing units (162,000) account for 0.6 per cent of stock. Less than 10 per cent of older people are estimated to live in specialist housing (Pannell et al 2012). Furthermore, owners of retirement apartments tend to represent a narrow demographic. Indeed, those met within Pink & Knight’s villas were predominantly middle-class, older people in their late 70s, of White British ethnicity and with a degree of financial security and relative property wealth.
2 - Specialist accommodation
- Sam Clark, Cardiff University
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- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 21-28
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Summary
The previous chapter referred to recent public consciousness around societal ageing in the UK, specifically the housing needs and aspirations of older people. Of course the challenge of accommodating older persons is not new; historical accounts indicate special provisions being made during medieval times. One could reference acts of charity or ‘the giving of alms’, going back to the Apostolic Age. However, these were not targeted provisions. Good intentions were generally directed towards ‘the less fortunate’, with no active discrimination by age. Many of the older members of society would have been among the general ‘poor’, receiving alms from religious houses, if not supported by their family members. This chapter, therefore, explores the evolution of specialist accommodation for older people.
Monastic orders were perhaps the earliest communities to make special provision by way of dedicated accommodation for their elders. According to Howson (1993), monks would care for their aged and infirm brothers in the ‘farmery’, from which the name ‘infirmary’ is derived. The farmery was one of the extra-claustral buildings in the outer court of a monastery, usually on the quiet side of the precinct away from the hustle and bustle of public life. In its simplest form the farmery would be an oblong, aisle-less hall, similar in plan to a modern hospital pavilion, with a chapel projecting eastward from the end or side according to the position of the hall. Beaulieu Abbey is a good example, albeit ruined walls are all that remains of the farmery. Elsewhere, if the hall was too wide for a single structural span it was furnished with aisles and a stone arcade like a church. Webb (1921) describes how monks were accommodated in beds positioned along the outside walls and served nourishing meals from a special kitchen. With the exception of travellers, monasteries did not cater for laymen and women. Howson (1993) states that the practice of providing alms on site, as board and lodging to local people, did not emerge until the 12th and 13th centuries.
Contemporary with these forms of monastic accommodation were socalled bedehouses, hospitals, maison dieus and almshouses.
11 - Company architect
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 185-208
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Summary
Synopsis
This is a story told in a series of verse episodes. Here poetic expression is used to capture the values of the development company architect – persons employed directly, rather than externally contracted or appointed – and cultural environment in which they perform their professional work. Five short poems represent key ‘encounters’ with in-house architectural staff working for Pink & Knight. The poems blend a range of research materials that stem from episodes of participant observation, collaborative working and social interaction. The poems are further accompanied by author notes that shed light on the contextual conditions that were pertinent to their making; dates, locations and situations are declared, as are the primary research materials used to construct the work. The text serves to give voice to – and isolate the practices of – the architect working within a company like Pink & Knight. In doing so the author (also an architect) reviews the position of co-professionals operating within a business-orientated context – the ‘other’ workplace. Readers might observe how retirement housing is considered otherwise by alternate architectural professionals; a difference typified by casting the object as either ‘product’ or ‘project’.
Methods
The rationale for presenting research in an alternative literary form was inspired by Laurel Richardson whose work reflects upon the norms of social science research writing. Richardson (2003) reminds readers that the written communication of research is the creative output of the researcher and is subject to a level of crafting and smoothing, albeit through formal modes constructed over time and consented by ‘scientific’ research communities. Richardson promotes poetic forms of representation, arguing that the construction of poems from interview material ‘does not delude the researcher, listener, or readers into thinking that the one and only true story has been written’. Poetic representation offers scope for readers to engage in reflexive analyses of their own. Poems bring readers into a more equitable position, inviting them into an interpretative labour, in much the same way that the researcher has laboured in relation to the interviewee’s interpretative labour.
Poems may also be considered more ‘true to life’ in terms of their formal characteristics. When people talk their speech is closer to poetry than prose. According to Tedlock (1983), pauses occupy nearly half the time [North] Americans spend talking.
Index
- Sam Clark, Cardiff University
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- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 279-288
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Part II - Villas
- Sam Clark, Cardiff University
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- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 77-78
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15 - Global outlook
- Sam Clark, Cardiff University
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- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 254-262
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Summary
Step change
In the UK there has been a tangible step change over the past decade in terms of heightened awareness of the housing needs of older people as well as material change within the construction industry, including increased range and quality of age-friendly housing. Park and Porteus (2018) assert that ‘homegrown’ examples are at least as good as the HAPPI case studies located within Continental Europe in 2009, suggesting that ‘if today’s best practice became tomorrow’s normal, and the rate of delivery increased significantly, we would be much better equipped to deal with the future’. Readers will recall the Introduction of this book traced specific tipping points and incremental change witnessed within the UK architectural industry, but also a commentary, within Part III, on how the profession under-values and under-rewards engagement in the housing sector more broadly. Without doubt there are increasing numbers of architects engaged in the development of age-friendly housing, yet the housing sector remains a less attractive place for architects to realise a critically acclaimed career. Popular notoriety, professional prestige, personal wealth and so on are more readily associated with ‘starchitects’ (Klimek, 2019) working in other sectors on different building typologies – typically high-profile public buildings with distinctive formal/aesthetic attributes that take on an iconic status.
Apart from housing, the business of designing individual, bespoke homes has been a mainstay of architectural practice since its origins. Commentators have observed that ‘the private house occupies a unique position in both the history of architecture and human imagination. Beyond its core function of shelter, it is an object of fantasy, a source of delight, a talisman and a testing ground’ (Architectural Review [AR], 2021). But architects also have an important contribution to make towards the design of high-quality volume housing, and there are some green shoots with respect to changing values and external recognition. For instance, in 2019, the Royal Institute of British Architects (RIBA) Sterling Prize was for the first time awarded to architects of a social housing project, Goldsmith Street in Norwich, England, designed by Mikhail Riches with Cathy Hawley. The first general-needs housing project to receive the Sterling Prize (2008) was Accordia in Cambridge, England, designed by Feilden Clegg Bradley Studios, Alison Brooks Architects and Maccreanor Lavington Architects.
8 - Villa manager
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 135-158
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Summary
Synopsis
This research story is written from the point of view of the villa manager; the person providing a concierge service to resident owners, and a property management service to the developer. The story opens with an exploration of the villa manager’s job description and provides the reader with a general background on this group of workers. The story proper takes the form of a ‘day in the life’ of a villa manager, Lindsey, providing a fictional account (based on real events) of the social world she helps to support and sustain. While there is a narrative plotline – the lead-up to a summer garden party – this is also a collection of micro stories, everyday occurrences and interactions in the work life of a villa manager.
The story reflects upon the villa manager’s shifting position, necessitated by engagement with an array of stakeholders, ranging from employers to customers and visiting others, including cleaners, maintenance workers and emergency services personnel. The story highlights the concerns of the villa manager, including grey areas between customer expectations and customer care. It also portrays something of the challenges presented by an ageing cohort of resident owners with collective ambitions to reshape the villa environment. The author’s intention is to give voice to the villa manager, as an expert in the field, providing critical feedback on the design and utility of the villa. The story also shines a light on how villa managers contributed towards research methods.
Methods
Several villa managers were met in the field; some for a matter of minutes, while touring a recently completed development, and others for longer periods of time. Initially managers were considered facilitators or gatekeepers in the research, helping the researcher to access resident owners – individually and within social groups – and organising overnight accommodation for research residences. But the researcher also became a participant observer of villa managers and their interactions with resident owners and others. Indeed there is scope for further research to adopt a more structured ‘shadowing’ method, explicitly observing and recording events experienced and shaped by managers, noting particular ‘touchpoints’ with the developer’s product and customers.
14 - Retirement reviewed
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 247-253
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Summary
Research anthology
This book has presented a series of research stories reflecting the multivariate positions of actors engaged in the design, construction, management and habitation of retirement housing in the UK. It is an anthology of sorts, comprising stories that offer ethnographic ‘thick descriptions’ of stakeholders situated within their respective sites, settings and subcultures. The stories within Parts I, II and III of this volume could be separated into two alternative categories: (i) those relating to a production context – developer director; architecture student; company architect; town planner, and (ii) those relating to the inhabitation of architecture – baby boomers; vulnerable friend; resident owner; villa manager. The latter group could be said to meet the idea of stories as a means for ‘making sense of both individual experience of architecture and social interactions that take place in it’ (Frascari, 2012), and therefore have potential to feed into future stories in support of making age-friendly architecture. Certainly it is hoped that this work will enable different stakeholders and/ or disciplines within the retirement housing sector, including divisions within companies and organisations, to better relate to each other’s positions, knowledge and everyday practices. Each story contains a multitude of insights that are brought together in this summary chapter in order to help readers make sense of a design world in which we should all be invested.
Part I of this book provided a contextual review of the older-person landscape in the UK. It contained two stories that recounted the contrasting positions and experiences of persons with and without financial reserves and, therefore, differing degrees of choice. In Chapter 3, Baby boomers, the Cees were found to be resisting existing retirement accommodation offers; housing options considered ‘not for them’ or at least ‘not yet’. Yet their story revealed a level of unfamiliarity with retirement products in-theflesh; a situation that led the Cees towards misconceptions of retirement housing and inappropriate associations with residential institutions. The Cees also evidenced back-of-mind thinking around vulnerabilities, in terms of future physical and/ or psychological setbacks, and the adaptability of their home environment to meet their needs.
7 - Resident owner
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 110-134
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Summary
Synopsis
This research story opens with an exploration of different characterisations of the resident owner; each attempt to distil a diverse group of people into a single identity that is easily imaged and ‘handled’ as a touchstone would be. It also reflects the positions of resident owners met in the field. Groups of respondents contributed to an understanding of ‘home identities’ and ‘motives for moving’, as well as providing candid feedback on the retirement-living lifestyle and product in which they are invested. Contextual interviews – conducted with informants inside their homes, walking and talking through their interiors – reveal tacit knowledge, including an array of domestic ‘niggles’ and ‘snags’. Furthermore, the story presents narrative accounts of three case study characters – Patrick, Gladys and Paula – that both affirm and contest assumed consumer profiles, while casting doubt on aspects of the developer’s image of its customer.
Methods
A wide variety of settings were visited, and informants met, during fieldwork undertaken between September 2014 and December 2016. Four specific villas are referenced within this chapter and are listed here in alphabetical order by pseudonyms that are locationally determined:
• Avon Villa: an urban scheme on the outskirts of Bristol city centre, comprising 65 apartments, built in 2012.
• Beachwalk Villa: a near seaside scheme in central Worthing, West Sussex, comprising 29 apartments, built in 2014.
• Downland Villa: a suburban scheme in a dormitory area of north Worthing, comprising 39 apartments, built in 2012.
• Wealden Villa: an edge of town scheme in Royal Tunbridge Wells, Kent, comprising 38 apartments, built in 2007.
The aforementioned settings represent distinct types of ‘destination’ for moving retirees, ranging from a traditional coastline and Area of Outstanding Natural Beauty (AONB) through to an attractive city outside London. Each is in southern England as this was the primary business area for Pink & Knight at the time. The sample is also representative of Pink & Knight developments in terms of size, ranging from ‘small’ (29 units) through to ‘large’ (65 units).
Mixed methods were used across the four settings to inform a ‘multi-sited ethnography’ (Marcus, 2011) of the resident owners’ situations and cultures. The research involved short residencies at villas; staying overnight in the guest suite and engaging in the social life of the shared lounge, as well as conducting show-and-tell home visits.
4 - Vulnerable friend
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
- Published by:
- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 53-76
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Summary
Synopsis
This story presents a narrative account of my experience befriending ‘Rose’, a former nurse and legal aid worker; representative of the fastest growing section of the UK population – the so-called ‘old-old’ or those aged 85 years and older. In part I chose to become a ‘befriender’ as a way of supplementing my formal research activities and, somewhat subconsciously, to provide a counterpoint to outlooks gained from working with a property developer and its respective customers. In stark contrast to retirement villa residents, Rose was an older person with limited financial means and diminished mobility, dependent upon care workers and family members for her everyday needs. Through our relationship I gathered rich insights into multivariate meanings of home and everyday behavioural observations of an older person ageing in place. By the summer of 2016 Rose had moved into a purpose-built care home on the outskirts of her city, where she occupied a private room on the first floor, overlooking the road, until her death in January 2018. This story recounts her resistance to moving into the nursing home.
Methods
Prior to meeting Rose, I went through an application process involving an expression of interest, informal interview, training event and criminal records check. I declared my ‘researcher’ status and vested interest upon application and remained open to talking about my work with Rose and others. I visited Rose on a weekly basis, sharing a pot of tea and chatting for about an hour, or the time it took for the tea to go cold. From the outset, Rose expressed a welcoming and flexible attitude – “come whenever you like, daytime or evening” – rather than insisting on a fixed time, by appointment. This helped to make the arrangement feel more natural by lessening the sense of commitment or expectation. In practice I tended to visit mid-to late afternoon and always telephoned ahead. Rose got on well with the phone (she could direct sound into her good ear), but we always saved our chat for when we met face to face.
The role of the visiting befriender is to provide companionship. Befrienders do not assist with personal care, perform domestic tasks or administer medication.
9 - Professional context
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
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- Bristol University Press
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- 20 June 2023
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- 11 November 2022, pp 161-163
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Summary
Part III focuses on professional actors in the field of retirement housing and presents contrasting positions of architecture students, as prospective professionals; architects providing in-house professional services to property developers; and town planners working as ‘public servants’ within local planning authorities, making professional judgements on proposals for specialist housing schemes. What unites them is their professional standing, insomuch that they have specialist knowledge and skills acquired through extensive training, and they belong to a ‘disciplined group of individuals who adhere to ethical standards’ (Australian Council of Professions [ACoP], 2003).
The typical route to becoming a qualified architect in the UK involves five years’ study at university – usually a three years’ Bachelor’s degree and two years’ Master’s degree accredited by the Royal Institute of British Architects (RIBA) – and completion of a minimum of two years’ practical experience under the supervision and mentorship of an architect. The latter culminates in a professional exam after which architectural assistants can apply to register as an architect with the Architects Registration Board (ARB). Similarly, to work as a town planner in the UK you need a degree or postgraduate qualification accredited by the Royal Town Planning Institute (RTPI). To become a chartered town planner, you apply via one of four recognised routes to Assessment of Professional Competence (APC); typically a minimum of two years’ planning experience is required. Both registered architects and chartered town planners must comply with an independent code of professional conduct, hold professional indemnity insurance and undertake continuing professional development (CPD) throughout their careers to ensure their knowledge remains up to date. A key attribute of this professional status – arguably one that separates these professionals from businesspersons, construction contractors and tradespersons – is adherence to an ethical code of conduct that requires ‘behaviour and practice beyond the personal moral obligations of an individual’, specifically in ‘respect to the services provided to the public’ (ACoP, 2003). The RTPI Code of Professional Conduct makes explicit that the institute ‘exists to advance the science and art of planning for the benefit of the public’ (RTPI, 2016).
Within this context professional ethics are applied irrespective of commercial and/or personal interests, helping to ensure certain quality standards for the design of the built environment, including spaces between buildings, often referred to as ‘public realm’.
12 - Town planner
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
- Published by:
- Bristol University Press
- Published online:
- 20 June 2023
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- 11 November 2022, pp 209-228
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Summary
Synopsis
This research story captures the position of the town planner working within a UK Local Planning Authority (LPA), and their vital role in the regulation of housing for older people; being placed in-between housing providers and consumers, and ‘protecting’ the general public/ public realm. This is a fragmented story inasmuch that it pieces together research episodes and secondary source evidence. The story opens with an account of a planning inquiry where two representatives of a local planning authority – ‘Victor’ and ‘Rachel’ – were observed providing evidence and advancing a case for refusal of planning permission against a retirement housing scheme. Thereafter the author reflects upon a desktop study that examined regional planning policy and guidance in relation to retirement housing. The latter highlights an ongoing ‘identity problem’ with regards to retirement-living products and their passage through the English planning system. Furthermore, the story raises concerns regarding UK government ‘austerity’ measures and limited resources, including an apparent lack of retirement-living expertise within local planning authorities.
Methods
The primary research methods supporting this story are direct observation and a desktop study involving document analysis, as well as personal communications with planning professionals. Direct observation was undertaken at a planning inquiry where a Pink & Knight development was being considered following a local authority’s failure to give notice within the prescribed period for a decision to be determined on a planning application. While the desktop study examined planning policy guidance for three regions of southern England, each representing distinct types of ‘destination’ for migrating retirees: a traditional coastline, an inland Area of Outstanding Natural Beauty (AONB) and an attractive city outside the capital. Also included are the views of LPA professionals, captured through direct communications and online documentation, such as publicly accessible committee meeting minutes and reports.
Inquiry
The planning inquiry was held at a city Civic Hall; ‘home turf ‘ for the local authority being challenged. The building’s exterior had an impressive façade – a classical portico with giant Corinthian columns and pediment containing a coat of arms – serving to remind visitors of its civic importance as well as the implicit authority of public officials that meet within its interiors.
6 - Developer director
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
- Published by:
- Bristol University Press
- Published online:
- 20 June 2023
- Print publication:
- 11 November 2022, pp 88-109
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Summary
Synopsis
This is a tripartite story from the position of the property developer director, directing business, through the supply of retirement-living products to customers, for profit. Part A examines common perceptions of property developers within popular culture and the architectural profession. Part B presents ‘George’, a fictional director at Pink & Knight, and composite character based on members of the board of directors. It explores George’s success story – and ways in which it is maintained by himself and others – and Pink & Knight’s headquarters, which provide a seat of power and outward projection to the business community. The story then shifts from a narration of George, as character, to George as narrator. Part C presents George’s thinking around a staff symposium called ‘Back-To-Basics’, which is used by the author to roll-call Pink & Knight directors, as well as unpack everyday operational challenges and business decisions.
Methods
Part A is informed by an under-populated field of literature that seeks to bring together the two disciplines of architecture and property development (or real estate), combined with an analysis of Hollywood characterisations of property developers and British television footage, including a documentary presented by film-maker Richard Macer (2018). While the latter glosses over some major issues – like whether building on green belt land is appropriate – Macer’s strength is in ‘finding characters’ (Seale, 2018) and finding empathy for a property developer. This method of empathetic storytelling is translated into an account of Pink & Knight.
Parts B and C present a fictional character and narrative, respectively, based on real events, researched through participant observation and document analysis. Primary data was collected from everyday interactions within the headquarters of Pink & Knight. The author draws upon meeting notes made during research presentations to company directors; field notes made while observing internal meetings where directors were present; headnotes from interactions in-between meetings, including conversations with the planning director while travelling to and from developments, and a 300-mile car journey shared with the design director while travelling to a planning inquiry. Documents analysed include Pink & Knight’s ‘Annual Report & Accounts’; design documents, including planning drawings and a ‘Design & Access Statement’ for the recently extended head office; electronic presentation slides from the ‘Back-To-Basics’ symposium, which include the managing director’s address to staff and significant contributions from the design and planning directors.
Frontmatter
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
- Published by:
- Bristol University Press
- Published online:
- 20 June 2023
- Print publication:
- 11 November 2022, pp i-ii
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Dedication
- Sam Clark, Cardiff University
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- Book:
- Inside Retirement Housing
- Published by:
- Bristol University Press
- Published online:
- 20 June 2023
- Print publication:
- 11 November 2022, pp iii-iv
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