Importance of Design following a Catastrophic Injury

When an accident results in catastrophic injuries, the individual’s home is often no longer suitable for their needs.

lamp-icon.pngNick Bracegirdle, Building Surveyor at Jonathan Cornes Associates, specialises in the design of accommodation for people with disabilities.

In personal injury and clinical negligence litigation, Nick acts as expert witness, assessing the accommodation needs of the individual. Here, he explores the importance of good design in removing all possible barriers to independence, while also reducing unnecessary costs.

As an expert witness, whether on behalf of the claimant, defendant or as a single joint expert (SJE), early involvement in the case provides us with the best opportunity to deliver detailed reports that quantify accommodation claims.

Home improvements

Accommodation reports are critical to ensuring the individual has a home that not only meets their needs, but also gives them some of their former independence. In the first instance, we work with an occupational therapist (OT) in order to better understand the needs of the person involved.

The OT often works closely with the individual and has an in-depth knowledge of their disability and particular requirements. It’s our job to extract relevant information from their report, from specific equipment such as a ceiling track hoist or specialist WC to special considerations due to the size or layout of a wheelchair, and include it in the accommodation report.

Why use a Building Surveyor?

One advantage of using a Building Surveyor for the accommodation report is that we have detailed knowledge and understanding of property, how they are constructed and their inherent defects. This means that we consider a range of alternative ways to adapt a property, ensuring the individual has the space they require to meet their long-term needs in the most appropriate way. Another benefit is that we can provide a more holistic view on the property. For example, at the acquisition stage if we are considering two properties that are both ideal for purchase and adaptation, how would we decide? As Building Surveyors we can highlight any issues and assess the cost – such as if one of the properties needs the roof to be overhauled or has a dated electrical system and needs a rewire. This can help to make a decision between the two properties, but it can also be used as a tool to negotiate a reduction in the sale price.

One design does not fill all

Often it’s not feasible to adapt the individuals existing home to meet their long-term needs, but there are other options. A suitable property can be sought, purchased and adaptations made. Alternatively, a plot of land can be acquired so that a bespoke, purpose-built home can be developed. With both of these options, planning advice, design proposals and costings are critical pre-acquisition.

A considered design can successfully remove barriers to independent living. But the obvious solution is not always the most suitable or the best use of the funds available. For example, if the individual is paralysed following a spinal injury, the assumption is made that a bungalow is the most appropriate choice of accommodation, but this does not have to always be the case.

It can be difficult to find a traditional bungalow, especially one that has enough space to accommodate the internal modifications needed for a wheelchair user. If you need to extend the property, it can also prove difficult to find a bungalow that has enough land to build a suitable extension. Adapting a bungalow can be a costly option, especially if the property is not surveyed and the design does not fully consider the individual’s specific requirements; there is no ‘one design fits all’ scenario and good design takes take.

A two-storey or split level property should therefore not be discounted, as the installation of a lift can be a cost-effective solution. Although internal ramps are often considered, they can take up a lot of space and be intrusive and ugly, so should be avoided where possible.

Whether opting for a single or split level property, its layout, size and the juxtaposition of rooms needs to be carefully considered during the pre-acquisition and design stages. While it’s important to understand the person’s needs in relation to their disability, it’s equally as important to consider the family as a whole. For example, during one project, I designed the home of a lady with paraplegia, who also had a young child. When scheming the initial layouts of the rooms we had to ensure her child’s bedroom was easily accessible from the main bedroom.

A home for life

Future-proofing is an important part of the design process; assessing the short-term needs of the individual, but also taking into consideration how their health or disability might alter in the years to come, and what impact it could have on their independence.

Project Management

For me, adapting homes for people with disabilities is a hugely rewarding aspect of my job. The individual has to cope with the fact that their life has changed dramatically, our aim is to design and provide a home that only meets their long-term needs but also gives them back some of their former independence without unnecessary stresses.

For instance, I had a client who felt strongly that she did not want her en-suite to look like a disabled bathroom. Being paraplegic however, she required some assistance to get into and out of the bath, our solution was to install a more ‘traditional’ bath but with a tiled seating plinth around so she could transfer onto the plinth then into and out of the bath as opposed to using a hoist. During the adaptation works, we also strengthened the ceiling in the bathroom however, so that when hoist becomes necessary at a later stage, it can be easily installed.