Standard For Old Age PDF

INTRODUCTION
GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES
www.safeworksa.sa.gov.au
www.workcover.com
Disclaimer
The information produced by SafeWork SA and WorkCover Corporation of South Australia in this publication is correct at the time of printing and is provided as general information only. In utilising general information about workplace health and safety and injury management, the specific issues relevant to your workplace should always be considered. This publication is not intended as a substitute for the requirements of the Workers Rehabilitation and Compensation Act, 1986 or the Occupational Health Safety and Welfare Act 1986.
Limitations of Liability
To the best of our knowledge, the procedures described in this document reflect currently accepted practice, but cannot be considered absolute and universal recommendations. All recommendations must be considered in view of the specific example and new information that has become available since the time of writing. The authors disclaim responsibility and assume no liability for any adverse affects resulting directly or indirectly from the suggested procedures, from any undetected errors, or from the readers misunderstanding of the text.

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ACKNOWLEDGEMENTS:
These guidelines have been prepared by the SAfer Aged Care Industry Working Party; in conjunction with the Health and Aged Care Sector. Acknowledgements are extended to:
Safer Aged Care Safe Design Steering Committee

Brian Adams, SafeWork SA Sue Balde, SA Unions Richard Coker, University of South Australia Ingrid Ormay, SafeWork SA Theadora Papadopoulos, Karidis Corporation Limited CS Wong, SafeWork SA
Case Studies
Annda Hope Valley Residential Care Eldercare Incorporated SA Southern Cross Care (SA) Incorporated
Additional acknowledgements to:

Nic Doncaster, WorkCover Corporation Susan Ellis, Resthaven Incorporated Jim Klesyk, Helping Hand Aged Care Necia Michel, Walter Brooke & Associates Pty Ltd Valerie OKeeffe, Workplace Services Angela Sparrow, WorkCover Corporation
David Stevens, David Stevens Consultancy Liz Bluff, The Australian National University WorkSafe, Victoria Queensland Health, Capital Works Branch
Design and produced by:

SafeWork SA, www.safeworksa.sa.gov.au WorkCover Corporation of South Australia, www.workcover.com

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HOW TO USE THESE GUIDELINES:

These guidelines are intended to provide general best practice information about safe design for the aged care industry. They are intended as a starting reference point for considering safe design as part of the development/redevelopment of a facility and/or a product. They are to be read in conjunction with the national (1) publication Guidance on the Principles for Safe Design at Work . The needs of residents and service providers, site requirements, budgets and management will have implications for the overall design and safe design features of a building project. The industry is encouraged to share best practice in a collaborative fashion in using these guidelines. This information is of a general nature and it is understood that affordability, sustainability and funding implications for a site/product will have a bearing on the final design. However, an innovative and efficient design solution can be achieved by the proprietor/developer with a degree of flexibility. The guidelines are intended for those within the Aged Care Industry with responsibilities for planning, designing, operating, maintaining, altering, and decommissioning a facility; and its associated layout, plant and equipment, substances and work systems. This includes persons with control: owners, occupiers, directors of nursing, architects, interior designers, suppliers, installers, designers and manufacturers of plant and equipment and anyone who may be involved at any stage during the lifecycle of the facility and associated plant.
Guide to the Safe Design of Aged Care Facilities
Guidance on the Principles of Safe Design at Work.
Refer to Principles of Universal Design
Refer to Considerations for Safe Design
Consider the Safe Design Process Steps: 1 8
Refer to Practical Examples: 1 24
Refer to Links for detailed information
Input into the design process
(1)
Australian Safety and Compensation Council, Guidance on the Principles of Safe Design at Work, Australian Government, Canberra, 2006

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TABLE OF CONTENTS
Page Acknowledgements How to use these Guidelines 1 1.1 1.2 1.3 1.4 1.5 Introduction Why Safe Design? What is Safe Design? Universal Design Principles Considerations for Safe Design Reasonably Practicable Industry Case Study 1, Annda Hope Valley, Hope Valley, South Australia, Ceiling lift technology 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 2 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 OHS Responsibilities for Design Consultation Global Directions Ageing in Place and Emerging Issues Design for Dementia Design for Palliative Care Overhead Lifters Design for Disassembly Culturally And Linguistically Diverse (C.A.L.D.)/ Aboriginal and Torres Strait Islanders Practical Examples Common requirements for all room functions En suite/bathroom design Bedroom design Dining room design Office areas design Laundries design Kitchen design Storage room design Common rooms design Pharmacy/drug rooms design Nurses stations design Toilets design Corridors design Lounge rooms design Spiritual area / Hall design Hairdressers area design 3 4 7 7 7 7 8 9 11 12 14 14 14 15 15 16 16 16 18 19 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

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INTRODUCTION 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 3 3.1 3.2 3.3 Caf / Internet caf area design Maintenance area design Pan/sluice room design Reception area design Therapy area design Dressing room (clinical) design Doctors room design Training room design Outdoor areas design The Principles and Process of Safe Design Levels and areas of responsibility The Safe Design Process Steps Risk Management Industry Case Study 2, Eldercare Incorporated SA, Risk Management 3.4 3.5 3.6 Development of aged care facilities: a seven step guide Business efficiency Sustainability Industry Case Study 3, Southern Cross Care (SA) Incorporated, Sustainability and Safe Work design 3.7 Lifecycle stages of various product types Appendices A B C D Definitions Aged Care Industry - Generic Hazard Register Pre-purchase criteria for equipment and products Type, frequency, nature and cost of injuries and illness References Australian Standards 37 38 39 40 41 42 43 44 45 46 46 46 51 53 54 57 57 58 59 60 61 63 63 63 64 64

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1. INTRODUCTION
These guidelines have been developed in consultation with key industry stakeholders, including employer and employee representatives, to assist organisations within the Aged Care Industry in South Australia in the safe design of facilities and equipment. The guidelines aim to provide persons embarking on design projects with a clear set of guidelines that will enable a balanced outcome that will meet not only the requirements of compliance codes and regulations but will also meet the needs of the residents/clients. The guidelines endeavour to assist in the provision of a satisfactory standard of comfort and care in a pleasant and safe environment. The guidelines consider the legislated Occupational Health Safety and Welfare requirements, and the roles and responsibilities of owners and designers in safe design. The guidelines have been developed to support other legislation, codes and standards that control the general aspects of product safety, such as the: Building Code of Australia, the Development Act, Trades Practices Act and the Electrical Products Act.
1.1 WHY SAFE DESIGN?

Safe design eliminates any OHS hazards and minimises any potential OHS risk, by involving decision makers and end users when considering the life cycle of the designed-product. A safe design approach will generate a design option that eliminates OHS hazards or minimises the risks to those (2) who make the product and to those who use it. Safe design may offer cost benefits and improved efficiencies throughout the lifecycle of the building and/or product. These guidelines are not intended to be prescriptive, and recognise that there will be cost limitations for the development, redevelopment, refurbishment and production of buildings and products. The initial cost, ongoing running costs, and other costs associated with the lifecycle of the building/product needs to be considered.
1.2 WHAT IS SAFE DESIGN?

Safe design is a risk management approach to the design process that eliminates OHS hazards and minimises potential OHS risks, by involving decision makers when considering the life cycle of the designed product. Safe design can be applied through the life cycle of the designed-product whether in the: construction, use, maintenance or demolition of any building or structure manufacture, supply, installation, use, maintenance or disposal of plant or equipment manufacture, supply, use or disposal of chemicals implementation or use of any system of work or process or any other physical attribute or system associated with either the workplace or the interface with people. These guidelines align with the Australian Safety and Compensation Council: National OHS Strategy 2002-2012 Eliminate the hazards at the design stage.
1.3 UNIVERSAL DESIGN PRINCIPLES

The needs of older people vary significantly from person to person. The principles of Universal Design encourage the design of products and the environment for use by all people to the greatest extent possible, without the need for adaptation or specialised design. The seven major principles of universal design indicate a product or feature should: provide equitable use The design is useful and marketable to people with diverse abilities
be flexible in use - The design accommodates a wide range of individual preferences and abilities
(2)
Australian Safety and Compensation Council, viewed 24 November 2006 www.ascc.gov.au/ascc/HealthSafety/SafeDesign/Understanding/Whatissafedesign.htm

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INTRODUCTION be simple and intuitive to use - Use of the design is easy to understand, regardless of the user's experience, knowledge, language skills, or current concentration level convey perceptible information - The design communicates necessary information effectively to the user, regardless of ambient conditions or the user's sensory abilities provide tolerance for error - The design minimizes hazards and the adverse consequences of accidental or unintended actions require low physical effort - The design can be used efficiently and comfortably and with a minimum of fatigue provide sufficient size and space for approach and use of the feature - Sufficient size and space is provided for approach, reach, manipulation, and use regardless of user's body size, posture, or mobility Note: a limitation to the principles of Universal Design is that the principles address only universally usable design, whereas the commercial practice of design involves a broader consideration than simply for usability. Designers must consider economic, engineering, cultural, gender, and environmental concerns as well as safety in their design processes. The Universal Design principles offer designers guidance to better integrate features that meet the needs of as many users as possible. All principles may not be relevant to all designs.
For further information refer to:

Center for Universal Design (1997) Principles of universal design. www.design.ncsu.edu/cud/about_ud/udprinciples.htm Crews, D.E and Zavotka, S. Aging, Disability and Frailty: Implications for Universal Design (2006), Journal of Physiological Anthropology, 25: 113-118, 2006
1.4 CONSIDERATIONS FOR SAFE DESIGN

The principles of safe design are as follows:
1.4.1 There is an understanding of the health and safety requirements of the design
Decision makers are aware of their responsibility for the safety of downstream users and beneficiaries. Decision makers understand their obligation under law to design and supply a safe product by eliminating OHS hazards and controlling for residual OHS risk. Health and safety is considered with equal priority to other design requirements in an overall risk evaluation of the designed-products life cycle. Decision makers ensure that the most current knowledge of OHS principles, materials/technology and systems are applied in the design of the product. Education, training standards and protocols support the requirement for decision makers to have appropriate skills to identify and eliminate OHS hazards, and control OHS risks in the design phase.
1.4.2 There is systematic hazard identification and risk evaluation

Decision makers identify OHS hazards and analyse the associated risks across the life cycle of the designedproduct. There is consultation during the concept and detailed design phases between all people involved with the designed product to make use of their knowledge and experience to identify and eliminate OHS hazards and minimise risk. (These people may include, but are not limited to, the commissioning agent, manufacturers, builder, users, employees, importers, suppliers, maintenance agencies, contractors, installers, distribution agencies and disposers). There is a systematic assessment of the probability and consequences of injury or illness arising from exposure to identified OHS hazards, which guides the selection and implementation of the most appropriate OHS risk controls for the designed-product. Decision making during the risk evaluation process is documented and made accessible to all parties.

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1.4.3 Interaction occurs between people involved in the life cycle of the designed-product
Decision makers are aware of the life cycle of the designed-product (including, but not limited to, its design, construction/manufacture, supply/installation, use, maintenance/servicing, decommissioning, and disposal). Decision makers consider the range of people who will use or otherwise interact with the designed-product. Consideration is given to the OHS hazards that might arise during the designed-products life cycle, including those due to environmental and human factors. Relevant residual risk information in the designed-product is communicated to those who will use or interact with the designed product throughout its life cycle. Consideration is given to the potential disease and injury costs when assessing life cycle operating costs (including, but not limited to, environmental clean up, decommission/dismantling, redesign/retrofit).
1.4.4 Contractual arrangements and procurement systems operate to minimise purchased OHS risk
Purchasing and contractual arrangements (e.g. specifications, supplier pre-qualification and tender documentation) include a requirement to eliminate OHS hazards, minimise OHS risks, and provide residual OHS risk information. The design brief or draft specifications include an agreement to carry out a safe design approach. The agreement also includes production of a life cycle OHS risk evaluation and a residual risk register. The designed-product includes fail-to-safe strategies for possible failure or defect impacts.
1.4.5 A sustainable designed-product result

The design is monitored as it evolves to identify new OHS hazards and manage each risk as it becomes evident. If alterations to the designed product are planned during its life, a systematic OHS risk evaluation is conducted in the planning and design stages to eliminate OHS hazards and minimise risk. Information relating to any new risks are fed back to the designer/manufacturer.
1.5 REASONABLY PRACTICABLE

OHS legislation requires duty holders to do what is reasonably practicable and recognises that this can occur only in situations over which the duty holder has control. Contractual arrangements between the owner of a proposed product and its designer may have influence over who has control in any situation. Deciding what is reasonably practicable may depend on the level of risk for any given situation, past experience of those involved, what is widely known about the hazard, and the effectiveness and cost of its control strategies.

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INDUSTRY CASE STUDY 1 Annda Hope Valley, Hope Valley, South Australia Ceiling lift technology
The proprietors of Annda Hope Valley residential aged care facility investigated the use of ceiling mounted electrical hoists in developing Stage 1 of their 71 bed facility. They considered the devices, researched the issues involved in installing the devices into bedrooms and en suites, and conducted a cost analysis. They considered the benefits of fixed systems verses the portable systems available. In a portable system, the motor can be detached from the tracking and used across a variety of rooms. In a fixed system, the motor is attached to the tracking and dedicated to a specific room. The design considered the various configurations of the tracking for over the bed, bed to chair, and bed to en suite. The devices and tracking are available in straight/curved sections, turntable junctions which allow for a change in direction; a transverse system allowing for two-way movement (up/down and across); fixed to the ceiling; suspended from the ceiling or recessed into the ceiling; various weight capacities up to 360kg. Additional structural members in the ceiling were considered in the design to take the load. The main challenges involved the design and layout of the bedroom and en suite given the fixed position of the tracking. The aim was to make resident handling safer and more efficient, require minimal physical exertion, and reduce the requirements for storage space for mobile lifters. The hoists were also considered easy to use regardless of the floor surface, as some textured floor surfaces make it difficult to manoeuvre mobile hoists. Staff required training in use of the devices. In making the decision to install the ceiling hoists, the organisation considered: compliance with Australian Standard AS ISO 10535-2003:Hoists for the transfer of disabled persons Requirements and test methods checking with the building surveyor that fire safety requirements were not compromised weight and noise of the motor comfort and dignity of the resident aesthetics and compatibility with the home like environment charging requirements. The final design solution and safe work requirements put in place by the organisation are detailed in the photos and building plan below. The organisation has been pleased with the staff and resident response to using the ceiling lift technology and has incorporated provision for more ceiling hoists to be installed in stage two of their facility development. Refer to the obligations under the OHSW Regulations 1995 (S.A.) 1.3.2 and 1.3.3 to conduct hazard identification and risk assessment, and implement control of risk. This requirement encompasses the life cycle impact to all persons associated with a facility; and the subsequent and ongoing requirement to create and maintain a risk register.

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INDUSTRY CASE STUDY 1 Annda Hope Valley, Hope Valley, South Australia Ceiling lift technology
Photos 1-3: illustrating ceiling mounted electrical hoists.
Photo 1
Photo 3 Photo 2
Plan 1: Illustrating design and layout of the bedroom and en suite and path of lifter track.

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1.6 OHS RESPONSIBILITIES FOR DESIGN

Designers of a product that is associated with a workplace, whatever that product may be, have responsibilities under OHS legislation to ensure their design is inherently safe throughout all stages of its life cycle. Refer to OHS&W Act 1986 (SA), Section 23A and 24, printed below. Owners of a product that is associated with a workplace, also have responsibilities to ensure that the product, (a building, building addition or extension, item of plant or equipment, substance or work process) is safe. These responsibilities of both the owner and designer are in addition to any responsibilities described under other legislation such as the Development Act, Trade Practices Act or the Electrical Products Act. Designers may also have contractually enforceable obligations to the products prospective owner under their design commission and brief, which may guide the direction and extent of the designers work and may instruct the designer in relation to some issues, such as acceptance/rejection of some design change proposals. Contractual issues may lead to concomitant responsibilities for product safety; both the designer and owner having responsibility to ensure the product is safe throughout its life cycle, but with the owner having some control over the extent and direction of the designers work. Contractual agreements between an owner and designer do not derogate from their legislated responsibilities under OHS legislation.
Occupational Health Safety and Welfare Act 1986 South Australia (Version 15.8.2005) Section 23A Duties of designers and owners of buildings
(1) A person who designs a building that is reasonably expected to comprise or include a workplace must(a) ensure so far as is reasonably practicable that the building is designed so that people who might work in, on or about the workplace are, in doing so, safe from injury and risks to health; and (b) ensure that the building complies in all respects with prescribed requirements (if any) applicable to it. (2) The owner of a building that comprises or includes a workplace must(a) ensure so far as is reasonably practicable that the building, and any fixtures or fittings within the building that are under the control of the owner, are in a condition that allows people who might work in, on or about the workplace to be safe from injury and risks to health; and (b) ensure that the building complies in all respects with prescribed requirements (if any) applicable to it. (3) In this section - building includes a part of a building.
Section 24 - Duties of manufacturers etc

(1) A person who designs, manufactures, imports or supplies any plant to which this subsection applies must(a) ensure so far as is reasonably practicable that the plant is designed and constructed so as to be safe(i) when properly used and maintained; and (ii) when subjected to reasonably foreseeable forms of misuse; and (b) ensure so far as is reasonably practicable that the plant is designed and constructed so that people who might use, clean or maintain the plant are, in doing so, safe from injury and risks to health; and (c) take such steps to test or examine, or arrange for the testing or examination of, the plant as are reasonably necessary to ensure compliance with paragraphs (a) and (b); and (d) ensure that the plant complies in all respects with prescribed requirements (if any) applicable to it; and (e) ensure so far as is reasonably practicable that adequate information about any conditions necessary to ensure the safe installation, use and maintenance of the plant is supplied with the plant.
(2) A person who erects, installs or modifies any plant to which this subsection applies must ensure so far as is reasonably practicable that it will be safeGUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES
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INTRODUCTION (a) when properly used and maintained; and (b) when subjected to reasonably foreseeable forms of misuse. 2aa) Subsections (1) and (2) apply to (a) any plant that is to be used, or reasonably expected to be used, at a workplace; and (b) without limiting the operation of paragraph (a), any plant to which this Act extends by virtue of Schedule 2. (2a) Without derogating from the operation of subsections (1) and (2), where any structure is to be erected in the course of any work(a) the person who designs the structure must ensure so far as is reasonably practicable that the structure is designed so that the persons who are required to erect it are, in doing so, safe from injury and risks to health; and (b) any person who manufactures any materials to be used for the purposes of the structure must ensure so far as is reasonably practicable that the materials are manufactured so that the persons who are required to erect the structure are, in using, handling or otherwise dealing with the materials, safe from injury and risks to health; and (c) any person who imports or supplies any materials to be used for the purposes of the structure must ensure so far as is reasonably practicable that the materials are in such a state as to be safe to any person who must use, handle or otherwise deal with the materials; and (d) the person undertaking the erection of the structure must ensure so far as is reasonably practicable that the structure is safe during the course of its erection and subsequent use. (3) A person who manufactures, imports or supplies any substance for use at a workplace must(a) ensure so far as is reasonably practicable that the substance is in such a state as to be safe(i) when properly used, handled, processed, stored, transported or disposed of; and (ii) when subjected to reasonably foreseeable forms of improper use, handling, processing, storage, transportation or disposal; and (b) ensure so far as is reasonably practicable that the substance is in such a state that persons who might use, handle, process, store, transport or dispose of the substance are, in doing so, safe from injury and risks to health; and (c) take such steps to test or examine, or arrange for the testing or examination of, the substance as are reasonably necessary to ensure compliance with paragraphs (a) and (b); and (d) ensure that the substance complies in all respects with prescribed requirements (if any) applicable to it; and (e) ensure so far as is reasonably practicable that adequate information about any conditions necessary to ensure its safe use, handling, processing, storage, transportation or disposal is provided in connection with the supply of the substance. (4) In this sectionstructure includes a part of a structure.

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1.7 CONSULTATION
Consultation is an important aspect of safe design. Designing what is required and what will work, without creating additional hazards or unnecessary increased workloads, can be achieved by including all end users in the design of products or buildings. Consultation involves the sharing of information and the exchange of views between people. In the workplace this is generally applied to the interaction between employers and employees. In the case of safe design, it involves the sharing of information between all persons involved in the development of the end product or building. Consultation ensures that everyone involved is made aware of hazards and OHS issues experienced by employees and residents and can take steps to eliminate them from any future designs of products or buildings. Consultation during planning of new work or work processes, and during identification, assessment and control of risks, provides a practical and effective platform for agreement and commitment for the prevention of work related injury and disease.
1.8 GLOBAL DIRECTIONS

Workplace safety and safe design is a key consideration globally. Health and aged care has been identified as a high risk industry for work place injuries. Research, policy and workplace interventions have been particularly progressive in countries such as Canada, United Kingdom, Netherlands, Sweden, Norway, Denmark, United States of America and Australia. In recent years, the global focus has been on eliminating or reducing hazards and injuries through promoting risk analysis of the work environment and practices, and implementing strategies to prevent injury. Strategies for the aged care industry include: the promotion of no lift policies, designing out potential risks in the development of new or redevelopment of existing facilities, and consideration of the principles of universal design. Studies on use of new technologies to support a safer work environment have also been undertaken. These include a focus on portable patient ceiling lift devices and the use of wireless technology.
For further information refer to:

The Construction Technologies Institute, unit of Rome 2006 Health, Buildings, Typologies, Quality and Safety www.roma.itc.cnr.it/vers_inglese/home_ing.htm The Living Lab Research to Facilitate Independent Living www.sfu.ca/livinglab Ontario Safety Association for Community and Healthcare www.osach.ca US Department of Labour Occupational Safety and Health Administration www.osha.gov European Agency for Safety and Health at Work www.europe.osha.eu.int/info Health & Safety Executive www.hse.gov.uk
1.9 AGEING IN PLACE AND EMERGING ISSUES

The capacity for design to enable older people to remain in their own homes and receive care, or receive a continuum of care in a retirement or residential facility without the need for continual relocation is an important design consideration. Design should be adaptable and take into account changes in peoples needs and levels of acuity, and the necessary involvement of others (carers, family members) in the designed space.
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INTRODUCTION Design for ageing in place requires consideration of the most dependent levels of resident need. Residents with high degrees of physical dependency often require greater space to allow staff to assist residents in a safe working environment.
For further information and links refer to:

Department of Health and Ageing www.health.gov.au/internet/wcms/publishing.nsf/content/ageing-publicat-ageplace.htm Design 4 Health National Manual Handling Campaign Industry Summary report (2005) www.safework.sa.gov.au - follow links to Industries > Community Services > Design 4 Health Valuing Older Workers: Preparing your business for an ageing workforce, Queensland Government Department of Industrial Relations 2005 www.dir.qld.gov.au/pdf/ir/olderworkers_booklet2006.pdf
1.10 DESIGN FOR DEMENTIA

Residents in a dementia specific unit or wing of a residential facility require expert and complex care in a specialised dementia program. The safe design of the building provides an opportunity to support behaviour management and provide appropriate stimulation and orientation for residents to function at their best. Designers need to consider issues that will influence behaviour; and which design features will enhance the dementia program. Such issues include: Stimulation and control of visual, acoustic, and movement aspects, as they relate to behaviour management of residents. Resident cues and interfaces which support behaviour management. The use of colour, form, finish, landmarks and multi-sensory design aspects should be considered. Enabling planned wandering through design features, including the relationship between the internal and external space, continuous paths, lighting and attractions. Providing a secure environment with flexibility and freedom of movement through personal, building and perimeter security Centralisation of daily activities around a core element of the facility (kitchen, lounge, dining room). Access to controls, equipment, items and spaces leading to inappropriate use by dementia residents should be designed out of such facilities. Issues of supervision, unauthorised access and potential for risk or harm to residents must be carefully evaluated.
For further information and links on dementia refer to:

Alzheimers Australia www.alzheimers.org.au Prevention and management of resistance to care report, Final report, J. Grealy, C&G Education and Research Pty Ltd, WorkCover Grant, South Australia www.safework.sa.gov.au/contentPages/Industry/AgedCare/agedResources.htm
1.11 DESIGN FOR PALLIATIVE CARE

The increasing levels of acuity within residential care facilities, Ageing in Place, and the desire for people to die in their home, makes palliative care an important consideration in the design of Aged Care environments. The avoidance of an institutional appearance and atmosphere is considered to be particularly important in relation to the need to take account of the complex emotions and perceptions of those in palliative care, as well as their family and friends.
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INTRODUCTION The creation of a domestic character may be assisted by: attention to the quality of light exploiting views use of colour selection of furniture and fixtures. The clarity of circulation is important through avoiding confusing or complicated circulation routes. The environment should offer privacy to palliative care residents and their families, as well as a quiet environment with a higher than normal level of sound containment and acoustic privacy. A higher than normal level of ventilation should be provided to minimise odours. Sheltered outdoor spaces should be created in and around the area.
For further information and links on Palliative Care refer to:

Palliative Care Australia www.pallcare.org.au
1.12 OVERHEAD LIFTERS

As No Lift procedures become more widely implemented as a means of reducing risks to workers and accidents overhead tracking is becoming an important consideration in the design of facilities. It is available as a portable system - where the motor can be detached and used in a variety of rooms, or in a fixed position. Transfers using overhead tracking require minimal physical exertion, reduced transfer and storage space, and generally require only one carer. The system is primarily used in over the bed transfers, in the bathroom, and therapy/specialist settings. In terms of the design of a room - adequate ceiling supports are required, the room layout will need to consider the position of the tracking, and a mobile hoist is still required for back up. The complexity of the system will depend on the resident mix, no lift policy, other lifting equipment used and the overall design of the facility. In addition, the issues of comfort and dignity for residents, noise, aesthetics, costs and potential savings (storage, staff time) and ease of using need to be considered. Structural considerations, even for future planned installation of overhead lifters, is more economic when considered as part of the original design.
For further information and links for overhead lifters refer to:
Australian Standard AS ISO 10535-2002: Hoists for the transfer of disabled persons - Requirements and test methods www.standards.org.au follow links to Australian Standards WorkSafe Victoria Designing Workplaces for Safer Handling of Patients/Residents - Guidelines for the design of health and aged care facilities, second edition 2002. www.workcover.vic.gov.au/publications
1.13 DESIGN FOR DISASSEMBLY

Products should be chosen which facilitate disassembly for repair and subsequent recycling of materials. Built environments should consider issues affecting modification or demolition of structures; including recycling of materials.
1.14 CULTURALLY AND LINGUISTICALLY DIVERSE POPULATIONS (C.A.L.D.) / ABORIGINAL AND TORRES STRAIT ISLANDERS
The design process needs to consider the needs of all users; including people from Culturally and Linguistically Diverse Populations (C.A.L.D.), and Aboriginal and Torres Strait Islanders. A range of multicultural resources and information are available to designers, planners and service providers. It is recommended that information is sought on design considerations as they relate to safe design and the target group(s).

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For further information and links refer to:

Multicultural SA www.multicultural.sa.gov.au Australian Department of Immigration and Multicultural Affairs www.immi.gov.au Aboriginal Health Council of South Australia www.ahcsa.org.au

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PRACTICAL EXAMPLES
2. PRACTICAL EXAMPLES
Environments (living and working)
Within Aged Care environments we must consider both the needs of persons receiving the care/service and the service providers. A range of hazards can be identified within these environments and should be assessed, controls implemented and evaluated to ensure a safe and healthy environment for both the care receiver and the service provider. Some of the hazards that are commonly identified in Aged Care environments include: Inadequate space provision to allow for equipment to be moved in and out of an area to assist in manual handling or for persons to freely move when using their wheelchairs or walking frames. Flooring that is slippery, uneven, or with differing textures makes moving of wheeled equipment difficult. Poor or inadequate lighting of the tasks or activities being undertaken, or, failing to meet specific individual needs. Radiated noise creating noisy built environments Poor security arrangements Lack of privacy or individual personal space needs Poor work flows Distances to storage areas for equipment required or inadequate amount of storage Colour schemes that whilst they look aesthetically pleasing create confusion for residents when seeking specific rooms. Ramps placed throughout facilities, making moving around and moving trolleys etc difficult, and creating unnecessary muscular manoeuvring exertion. Poorly designed or inadequate ventilation. Simple designs for ventilation are often the most effective and can cost a great deal less than complex mechanised and electrical systems. Long distances to toilets, lifts, common areas, and lounges. Furniture purchased for use in areas is large and cumbersome, not adjustable. There are common requirements for all room functions and environments which need to be considered in the design, and in conjunction with the specific requirements for each room. Examples are as follows:

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PRACTICAL EXAMPLES
2.0 COMMON REQUIREMENTS FOR ALL ROOM FUNCTIONS
Access
Door opening - clear width requirements Door swings - access and egress Door furniture specification requirements Sliding doors specification requirements
e-Links
www.workcover.com WorkSafe Victoria, Designing Workplaces for Safer Handling of Patients/Residents www.workcover.vic.gov.au then publications Transferring People Safely A Practical Guide to Managing Risk Queensland RACF Design Guidelines www.health.qld.gov.au/cwamb/agedguide/
Floor surfaces
Specification of non-slip surfaces Traversing between surfaces
Building Code of Australia (BCA) www.abcb.gov.au www.hermanmiller.com ergonomics
www.standards.org.au for these and other relevant Australian Standards AS1428 - Design for access and mobility
Lighting / ventilation / noise

Access to windows Florescent filters, Lighting levels, Increase lighting and reduce the contrasts in lighted areas Reduce glare from windows, Reflected glare on monitors Colour contrasts between walls and floors Minimise discomfort from thermal conditions - operating temps Air quality conditions - air movement, use of filters Chemical storage Acoustics and noise
AS4299 - Adaptable Housing AS1680 Interior Lighting AS1158 - Lighting for roads and public spaces AS3661 - Slip Resistance of pedestrian surfaces AS 1020 The control of undesirable static electricity AS3666 - Air handling & Water Systems of Buildings AS 1668 - The use of ventilation and air conditioning in Buildings AS1345 - Identification of the contents of pipes, conduits and ducts AS2441 - Installation of Fire hose reels AS 3000 - Electrical Installations AS 3008 - Electrical Installations Selection of Cables AS 3009 - Electrical Installations- Emergency power supplies in Hospitals AS 1768 Lightning protection AS 2107 - Acoustics Recommended design sound levels and reverberation times in building interiors AS 3671 - Traffic noise intrusion in buildings AS 4282 - Control of obtrusive effects of outdoor lighting

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PRACTICAL EXAMPLES
2.0 Common Requirements for all Room Functions (Cont./)
Safety and Environmental systems

Fire protection system - exits, doors, equipment, fire rating requirements for building and introduced materials, compartmentalisation, Electrical/network system - Light switches, plug outlets, cabling, lifts, Climate regulation system - heating, cooling, Infection control, water temperature/ flow rates, Water reticulation, pipe work and control of backflow, Materials selection - low emissions, fire rating,
e-Links
AS 1670 - Fire detection, warning, control and intercom systems AS 2118 Automatic fire sprinkler systems AS 2293 - Emergency escape lighting and access signs AS 2419 Fire hydrant installations AS 2441 Installation of fire hose reels As 2444 - Portable fire extinguishers and fire blankets AS 3745 - Emergency control organization and procedures for buildings AS 2500 - Guide to the safe use of electricity in patient care
Legislative requirements
Acts, Regulations and Guidelines
HB 260 - Hospital acquired infections Engineering down the risk AS 1470 - Health and safety at work
Equipment
Purchasing procedures - health and safety assessment and approval Consultation key stakeholders (i.e. residents, direct care staff) Information - sufficient information about the proposed design/product Compatibility - with the design of the building and work practices Space requirement - footprint/floor area covered by the new equipment Access requirements - storage space, floor surfaces compatible with the design of the equipment Staff movement - constraints, anchorages, supports, manoeuvrability
AS/NZS 2208 - Safety glazing materials in buildings AS 4485 - Security for health care facilities AS 3811 - Hard-wired patient alarm systems AS 1657 - Fixed platforms, walkways, stairways, and ladders
www.safework.sa.gov.au then Legislation
www.workcover.vic.gov.au/vwa/home.nsf/pages/so_ag ed pre-purchase guidelines www.dirp.qld.gov.au/pdf/whs/plant_code2005.pdf Plant Code of Practice

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PRACTICAL EXAMPLES
2.0 Common Requirements for all Room Functions (Cont./) Infection control considerations
Clinical waste - treated appropriately, contained and transported carefully. Arrangements for collection impact on design and the location, size and infrastructure of the aged care facility. Waste disposal facilities - clear access to waste disposal facilities, including sluices, section for storage of clean items should be carefully defined and protected from vapours, splashing or aerosols during procedures, hand washing, equipment washing, ultrasonic cleaning and reprocessing. Clinical hand basins - in all areas which resident treatment may occur with hot and cold water, non touch taps, supplies of liquid hand wash, and disposable paper towels. Taps should have anti splash devices. Impervious surfaces - areas for managing resident blood and body waste should have smooth impervious seamless surfaces without crevices Work areas - adequate lighting, good ventilation and suitable receptacles for the disposal of waste, easy access to equipment and safe storage for equipment not in use. Adequate bench space, at least one stainless steel sink or trough deep enough to accommodate instruments and other equipment requiring cleaning (double sinks are preferred), space for ultrasonic cleaners Cooling towers and water systems - meet Australian Standards Workflow - from clean to contaminated areas
e-Links
ANCAHRD Guidelines for blood and body fluid exposures www.health.gov.au/internet/wcms/publishing.nsf /content/icg-guidelines-index.htm www.safework.sa.gov.au
www.standards.org.au AS 4031 and amendment 1 and AS/NZ 4261 and amendment 1 AS 1668.2 and Supplement 1 or State/Territory guidelines. - ventilation AS SET 3500, AS/NZS 3666 and Standards Australia Handbook HB32, AS/NZS 3896 cooling towers and water systems AS/NZS 4187, AS/NZS 4815 - work flow
The following practical examples provide a guide to the safe design of a specific room function:

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PRACTICAL EXAMPLES
2.1 EN SUITE/BATHROOM DESIGN

Function: provision of bathroom facilities for residents.
Plan: sourced from Annda, Hope Valley, Hope Valley, South Australia
Workflow and Layout

Clear space on both sides of the toilet Toilet ideally located opposite door Manoeuvrability for carers, person and equipment
e-Links
WorkSafe Victoria, Designing Workplaces for Safer Handling of Patients/Residents www.workcover.vic.gov.au then publications Design Guidelines for Queensland Residential Aged Care Facilities www.health.qld.gov.au/cwamb/agedguide/
Sanitary ware
Shower floor gradient Shower alcove size requirements Lip to shower area Specification of basins Specification of grab bars in the bath/shower Support arms on both sides of the toilet and/or grab bars Ease of use of taps
www.standards.org.au AS 1428.1 - Design for access and mobility AS 3500 - Plumbing and Drainage AS 3661 - Slip Resistance of pedestrian surfaces AS 3666 - Air handling & Water Systems of Buildings AS 1668 - Interior Lighting
Considerations of use
Carers - assisting with transfers and personal care Ageing in place - provision for increasing dependencies Equipment type, dimensions, storage and access www.safework.sa.gov.au
Potential hazards / risks

Slippery/wet floors; space restrictions; inadequate ventilation; personal emergency - door locked; visual problems re: lighting/patterns/contrast

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PRACTICAL EXAMPLES
2.2 BEDROOM DESIGN

Function: provision of bed, personal affects/furniture.
Workflow and layout

Required clear space on both sides, and end of the bed Storage of wheelchairs/walking frames, television/entertainment equipment/computer Access to the en-suite bathroom
e-Links
WorkSafe Victoria, Designing Workplaces for Safer Handling of Patients/Residents www.workcover.vic.gov.au then publications Design Guidelines for Queensland Residential Aged Care Facilities www.health.qld.gov.au/cwamb/agedguide/ Building Code of Australia (BCA) www.abcb.gov.au www.standards.org.au AS1428.1 - Design for access and mobility AS4299 - Adaptable Housing AS3661 - Slip Resistance of pedestrian surfaces AS1680 - Interior Lighting AS3000 - Electrical Installations
Furniture / equipment
beds (variable widths) and wardrobes (built in/free standing) side tables and chairs - ergonomic requirements display cabinets, built in furniture lifting machine at foot end of bed medical equipment (eg. Nebuliser)
Carers - assisting with transfers and personal care Ageing in place - provision for increasing dependencies Change of use - rooms may be used for other purposes Equipment - a variety of equipment may be used
AS 2500 - Guide to the safe use of electricity in patient care
www.safework.sa.gov.au

Space restrictions; tripping points; non-electric beds; manual handling; uneven floors; sharp edges on furniture; poor levels of lighting/external glare; protruding bed controls; clutter, lack of adequate storage

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PRACTICAL EXAMPLES
2.3 DINING ROOM DESIGN

Function: serving of meals and various other activities of a social nature.
Workflow and layout

Space for the temporary storage of mobility equipment Proximity of furniture and space between dining tables to allow for easy transfer and manoeuvrability of residents Wheelchair and walking frame access Food service requirements Consideration of numbers of persons with regard to access & egress Access to alfresco dining
e-Links
WorkSafe Victoria, Designing Workplaces for Safer Handling of Patients/Residents www.workcover.vic.gov.au then publications Design Guidelines for Queensland Residential Aged Care Facilities www.health.qld.gov.au/cwamb/agedguide/ Building Code of Australia (BCA) www.abcb.gov.au
www.standards.org.au AS1428.1
tables and chairs - ergonomic requirements display cabinets, built in furniture servery/ buffet/mobile trolleys
AS 4688 Furniture Fixed height chairs
Carers - assisting with transfers and personal care Change of use - rooms may be used for other purposes

Space restrictions; tripping points, uneven floors; sharp edges on furniture; poor levels of lighting/external glare; clutter, lack of adequate storage

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PRACTICAL EXAMPLES
2.4 OFFICE AREAS DESIGN

Function: administrative tasks, storage of records.
Workstation design and layout

Horizontal surface and storage space needs for type of work Equipment requirements/data points/ adjustability Privacy requirements Display space / personalization Enclosed meeting spaces
e-Links
www.workcover.com www.safework.sa.gov.au Safeguard No. GS 43, GS 31, GS 66/2 Building Code of Australia (BCA) www.abcb.gov.au www.standards.org.au - for these and other relevant Australian Standards
Desks and chairs - Ergonomic requirements Filing cabinets, display cabinets, tables, built in furniture Separate room for photocopier
AS 3590 Screen based workstations AS 4438 - Height adjustable swivel chairs AS 1680 Interior lighting As 3080 - Telecommunications installations HB 59 Ergonomics
Change of use - rooms may be used for other purposes Equipment - a variety of equipment may be used www.safework.sa.gov.au

Space restrictions; inadequate ventilation; ergonomic hazards i.e. static postures; repetitive movements; trip hazards such as file drawers and electrical cables; security; lighting; inadequate space; limited storage; photocopiers; ventilation.

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PRACTICAL EXAMPLES
2.5 LAUNDRIES DESIGN

Function: washing and drying/folding of residents clothes.
Workflow and layout requirements

Demarcation of dirty linen from clean linen Ease of use of taps Sinks dimensions & positioning Cupboards Folding area, ironing facility
e-Links
Queensland RACF Design Guidelines www.health.qld.gov.au/cwamb/agedguide/
www.standards.org.au AS 4146 - Laundry Practice AS 1428.1 - Design for access and mobility
Washing machines and Dryers

Specification to meet load requirements for number of residents Height access for loading/unloading washing
AS 3500 - Plumbing and Drainage AS 3661 - Slip Resistance of pedestrian surfaces AS 3666 - Air handling & Water Systems of Buildings AS 1668 - The use of ventilation and air conditioning in Buildings
Chemicals
Direct feed system to reduce handling, contamination, Secure storage of chemicals
AS1680 - Interior Lighting
Use by residents (with mobility aids) Equipment - a variety of equipment may be used

Biological / infectious hazards; chemicals; temperatures; slippery/wet floors; space restrictions; Inadequate ventilation; build up of lint & noxious gasses in washing machine filter

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PRACTICAL EXAMPLES
2.6 KITCHEN DESIGN

Function: food preparation, serving, cold/dry storage of food supplies.
Workflow and layout requirements

Commercial Kitchen design guidelines Cooking/ reheating Serving Clean / dirty dishes flow Dry and cold stores Deliveries
e-Links
www.standards.org.au AS 1428.1 - Design for access and mobility
Furniture and Equipment

Commercial kitchen equipment
AS 3500 - Plumbing and Drainage AS 3661 - Slip Resistance of pedestrian surfaces AS 3666 - Air handling & Water Systems of Buildings
Cold storage
Fridge/ freezers Shelving/ height for access
AS 1668 - The use of ventilation and air conditioning in Buildings AS1680 - Interior Lighting
Safe Design of Commercial Kitchens
Equipment - a variety of equipment may be used
www.safework.sa.gov.au/contentPages/Industry/Ho spitality/Resources/hospResSafeDesignKitchens.ht m

Temperatures; chemicals; cold heat stress; electrical; machine guarding absent; latex allergy; non-ionizing radiation; sharp objects; steam; thermal burns; slippery/wet floors; space restrictions; inadequate ventilation; light pooling

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PRACTICAL EXAMPLES
2.7 STORAGE ROOM DESIGN

Function: storage of records, paper supplies, general supplies
Workflow and Layout

Ascertain total storage requirements Type of goods and equipment to be stored Minimum access requirements between shelving
e-Links
Shelving
Load requirements Reaching Height/ steps
www.standards.org.au AS 1428.1 Design for access and mobility AS 1470 Health and safety at work principles and practices AS 1940 The storage and handling of flammable and combustible liquids
Storage- a variety of equipment and items may be stored including records, paper supplies, general supplies

Space restrictions; poorly maintained step/ladders; inadequate ventilation; unstable shelving / height of shelving and stored items; cluttered

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PRACTICAL EXAMPLES
2.8 COMMON ROOMS DESIGN

Function: multi-purpose room for activities, relaxation
Workflow and layout

Allowance for Lounge chairs/ recliners and tables sufficient for number of residents Separation of activities passive/ active Television visual comfort and screen size/positioning Ease of movement Access and storage for wheelchairs and walking frames
e-Links
WorkSafe Victoria, Designing Workplaces for Safer Handling of Patients/Residents www.workcover.vic.gov.au then publications
Furniture & equipment

Lounge chairs/ recliners and tables Display cupboards/ sideboards Storage cupboards Audio visual
Building Code of Australia (BCA) www.abcb.gov.au
www.standards.org.au AS1428.1 AS 4688 Furniture Fixed height chairs
Carers - assisting with transfers and personal care Change of use - rooms may be used for other purposes Equipment - a variety of equipment may be used

Slippery/wet floors; space restrictions; inadequate ventilation; sharp edges; tripping; light pooling; visual problems re: patterns/contrast

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PRACTICAL EXAMPLES
2.9 PHARMACY/DRUG ROOMS DESIGN

Function: preparation/ management of medications, storage
Workflow and layout

Ascertain total storage requirements Type of goods and equipment to be stored high risk/ low risk Minimum access widths between storage areas
e-Links
Dispensing
Storage cupboards / shelves Secure storage for drugs/ medicines Preparation areas
www.standards.org.au AS 1428.1 Design for access and mobility AS 1470 Health and safety at work principles and practices AS 1940 The storage and handling of flammable and combustible liquids
Storage- a variety of medication and supplies Preparation - medications
AS/NZS 3816 Management of clinical and related wastes

Slippery/wet floors; heavy and poorly maintained drug trolleys; latex allergy; chemicals; hazardous drugs; sharps i.e. needles; space restrictions; inadequate ventilation

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PRACTICAL EXAMPLES
2.10 NURSES STATIONS DESIGN

Function: visual monitoring, administration tasks, records storage
Workflow and layout

Visual access to facility areas Access to records/ information/ computer Ergonomics for furniture Storage requirements
e-Links
www.workcover.vic.gov.au then publications www.safework.sa.gov.au Safeguard No. GS 43, GS 31, GS 66/2 Building Code of Australia (BCA) www.abcb.gov.au
www.standards.org.au
Furniture and equipment

Storage cupboards Benches/ desk Computer Medication trolley/ cupboard
AS 4438 Height adjustable swivel chairs AS 1680 Interior Lighting AS 3590 Screen based workstations AS 3080 Telecommunications installations HB 59 Ergonomics AS/NZS 3816 Management of clinical and related wastes
A variety of equipment may be used Administration Nurses, carers, visiting practitioners

Tripping; sharp edges; space restrictions; light pooling; privacy restrictions; work bench restrictions; noise; security

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PRACTICAL EXAMPLES
2.11 TOILETS DESIGN

Function: independent or assisted ablutions.
The functional area for a wheelchair bound patient/resident who requires assistance in a side transfer.
The functional area for a patient/resident who can stand on both legs. This transfer requires the option of two staff assisting by standing either side. The wheelchair is placed as shown in the diagram. This is also sufficient space for a patient to transfer with the help of a swivel board/turntable.
Workflow and Layout

Toilet ideally located opposite door Minimum access space around the toilet for manoeuvrability for carers, person and equipment Wheelchair and walking frame storage/ access to basin
e-Links
WorkSafe Victoria, Designing Workplaces for Safer Handling of Patients/Residents www.workcover.vic.gov.au then publications Queensland RACF Design Guidelines www.health.qld.gov.au/cwamb/agedguide/
www.standards.org.au
Sanitary ware/ equipment

Minimum Specifications and access space apply Support arms on both sides of the toilet Ease of use of taps
AS 1428.1 Design for access and mobility AS 3500 Plumbing and Drainage AS 3661 Slip Resistance of pedestrian surfaces AS 3666 Air handling & Water Systems of Buildings AS 1668 Interior Lighting
Carers/ family - assisting with transfers and personal care Equipment - a variety of equipment may be used www.safework.sa.gov.au

Slippery/wet floors; space restrictions; inadequate ventilation; personal emergency - door locked; light pooling; visual problems re: patterns/contrast

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PRACTICAL EXAMPLES
2.12 CORRIDORS DESIGN

Function: access to a variety of functions and spaces, flow pathways for people and equipment.
Clear width refers to the unencumbered space between the handrails.
The amount of clear width required in aged care facilities.
Layout
Impact resistance Minimum widths apply to trafficable areas Lines of sight Reduce obstruction ease of access and egress
e-Links
Furniture
Hall table & chairs in alcoves in some circumstances Handrails Fire safety equipment
www.standards.org.au AS 1428.1 Design for access and mobility AS 1470 Health and safety at work principles and practices AS 2441 Installation of fire hose reels AS 2444 Portable fire extinguishers and fire blankets
Clear access for beds/ equipment manoeuvrability Residents, carers, visitors


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PRACTICAL EXAMPLES
2.13 LOUNGE ROOMS DESIGN

Function: relaxation, watching television/DVD/video, games.
Workflow and layout

Allowance for Lounge chairs/ recliners and tables sufficient for number of residents Separation of activities passive/ active Television visual comfort and screen size/positioning Ease of movement Access and storage for wheelchairs and walking frames
e-Links
WorkSafe Victoria, Designing Workplaces for Safer Handling of Patients/Residents www.workcover.vic.gov.au then publications Queensland RACF Design Guidelines www.health.qld.gov.au/cwamb/agedguide/
Building Code of Australia (BCA) www.abcb.gov.au www.standards.org.au AS1428.1 Design for access and mobility AS 4688 Furniture Fixed height chairs AS/NZS 2107 Acoustics Recommended design sound levels and reverberation times in building interiors
Furniture & equipment

Lounge chairs/ recliners and tables Display cupboards/ sideboards Storage cupboards Audio visual
Carers - assisting with transfers and personal care Change of use - rooms may be used for other purposes Equipment - a variety of equipment may be used www.safework.sa.gov.au


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PRACTICAL EXAMPLES
2.14 SPIRITUAL AREA/HALL DESIGN

Function: spiritual fellowship, quiet contemplation,
Workflow and layout

Maximum numbers of users at any one time Access for wheelchairs and walking frames Visual comfort and lectern height/positioning Consideration of numbers of persons with regard to access & egress Impact resistance Minimum widths apply to trafficable areas Lines of sight
e-Links
WorkSafe Victoria, Designing Workplaces for Safer Handling of Patients/Residents www.workcover.vic.gov.au then publications Queensland RACF Design Guidelines www.health.qld.gov.au/cwamb/agedguide/ Building Code of Australia (BCA) www.abcb.gov.au
www.standards.org.au AS1428.1 Design for access and mobility AS 4688 Furniture Fixed height chairs AS/NZS 2107 Acoustics Recommended design sound levels and reverberation times in building interiors AS 1428.1 Design for access and mobility AS 1470 Health and safety at work principles and practices AS 2441 Installation of fire hose reels
Furniture
Lectern Religious items Chairs Tables Handrails Fire safety equipment
Carers - assisting with transfers Change of use - room may be used for other purposes Equipment - a variety of equipment may be used Clear access for resident wheelchairs / equipment manoeuvrability General public, visitors Recessed storage for equipment and supplies
AS 2444 Portable fire extinguishers and fire blankets

Space restrictions; inadequate ventilation; sharp edges; tripping; light pooling; visual problems re: patterns/contrast; blocked or locked egress routes; double door problems with travel paths; loose safety rails; splintered safety rails; slipping hazards from spills/wet floors; broken or torn flooring
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PRACTICAL EXAMPLES
2.15 HAIRDRESSERS AREA DESIGN

Function: grooming of residents hair. May incorporate beauty treatment in some circumstances and be used for other purposes.
Workflow and layout

Separation of activities washing/ drying/ beauty treatments Storage requirements/ Separation of storage for hair products Access and storage for wheelchairs and walking frames
e-Links
Basins and Furniture

Minimum Specifications for basins & wash area layout Manoeuvrability and positioning of chairs Ease of use of taps/ handheld shower outlets Storage cupboards
Building Code of Australia (BCA) www.abcb.gov.au www.standards.org.au AS1428.1 - Design for access and mobility AS 4688 Furniture Fixed height chairs AS 3500 - Plumbing and Drainage
Carers - assisting with transfers and personal care Equipment - a variety of equipment may be used

Slippery/wet floors; space restrictions; inadequate ventilation; personal emergency - door locked; light pooling; visual problems re: patterns/contrast.

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PRACTICAL EXAMPLES
2.16 CAFE/INTERNET CAFE AREA DESIGN

Function: meeting place for visitors, residents and staff to enjoy leisure time, eat/drink and use computers.
Photo sourced from Annda, Hope Valley, Hope Valley, South Australia
Layout
Ease of movement around tables & chairs Separation of activities (i.e. caf versus internet cubicles) Minimum access/ traffic flow pattern for sales counter Access and storage for wheelchairs and walking frames Bins/ rubbish removal Commercial kitchen design requirements
e-Links
Furniture
Tables & chairs Serving counter Computer visual comfort and screen size/positioning
www.standards.org.au AS1428.1 AS 4688 Furniture Fixed height chairs AS 4438 - Height adjustable swivel chairs
Carers - assisting with transfers and personal care Change of use - rooms may be used for other purposes Equipment - a variety of equipment may be used

Slippery/wet floors; inadequate ventilation; sharp edges; tripping; light pooling; visual problems re: patterns/contrast; ergonomic hazards from poorly laid out computer areas; lack of space for wheelchairs to access computers; overcrowding; slips from spills.

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PRACTICAL EXAMPLES
2.17 MAINTENANCE AREA DESIGN

Function: workshop activities, storage of supplies, tools, plant and electrical equipment, chemicals.
Workflow and layout

Workshop workflow requirements Storage requirements for portable & fixed equipment Minimum access widths and working area around machinery & equipment
e-Links
Furniture
Work bench - heights/ adjustability/ manoeuvrability Desk & chair/ notice board Shelving height and accessibility Garden equipment/ machinery
www.standards.org.au AS 1428.1 - Design for access and mobility AS 1470 - Health and safety at work principles and practices AS 1940 - The storage and handling of flammable and combustible liquids
Garage/ store of excess equipment & supplies Equipment - a variety of equipment may be used

Slippery/wet floors; space restrictions; inadequate ventilation; light pooling

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PRACTICAL EXAMPLES
2.18 PAN/SLUICE ROOM DESIGN

Function: disposal of blood and body waste, cleaning of equipment.
Workflow and layout

Storage requirements Access widths and working area around wash area Height of washing areas and washing hose hook-up
e-Links
www.standards.org.au AS 2437 - Flusher/sanitizer for bed pans and urine bottles
Basins and equipment

Minimum Specifications and access space apply Equipment for managing human waste Ease of use of taps
AS 1428.1 - Design for access and mobility AS 3500 - Plumbing and Drainage AS 3661 - Slip Resistance of pedestrian surfaces AS 3666 - Air handling & Water Systems of Buildings
Nurses/ carers/ cleaners Equipment - a variety of equipment may be used
AS 1668 - The use of ventilation and air conditioning in Buildings AS 1680 - Interior Lighting HB 260

Slippery/wet floors; space restrictions; inadequate ventilation; biological and infectious waste; chemicals; latex allergy; slips from spills; ventilation

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PRACTICAL EXAMPLES
2.19 RECEPTION AREA DESIGN

Function: phone reception, receiving visitors/members of the general public/contractors.
Workflow and layout

Exit and Entry traffic flow through main doors Reception counter positioned to avoid congestion Delineated waiting areas separate from traffic flow/reception Wheelchair and walking frame access/ storage Displays of information
e-Links
www.safework.sa.gov.au - Safeguard No. GS 43, GS 31, GS 66/2
www.standards.org.au - for these and other relevant Australian Standards
Furniture
Reception counter functionality and ergonomics Waiting chairs and tables ergonomics
AS 3590 Screen based workstations AS 4438 - Height adjustable swivel chairs AS 1680 Interior lighting As 3080 - Telecommunications installations
Public access/ visitors/ contractors Carers/ family - assisting residents Equipment - a variety of equipment may be used
HB 59 Ergonomics

Tripping / sharp edges/ space restrictions/ light pooling/ visual problems re: patterns/contrast; security; ergonomic hazards form poor workstation design

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PRACTICAL EXAMPLES
2.20 THERAPY AREA DESIGN

Function: provision of physiotherapy, occupational therapy, group therapy activities, treatment rooms/cubicles/screened areas.
Workflow and Layout

Required number of therapy suites/ cubicle Multi purpose therapy floor area as per service needs Waiting areas to suit wheelchair and walking frame access and storage Space around massage tables/ lifting equipment Hydro therapy - issues regarding pool safety/ traffic flow Storage requirements for therapy equipment
e-Links
Building Code of Australia (BCA) www.abcb.gov.au www.standards.org.au AS1428.1 AS 4688 Furniture Fixed height chairs AS 4438 - Height adjustable swivel chairs AS 2500 - Guide to the safe use of electricity in patient care
Furniture/Equipment
Provisions for lifting equipment/ ceiling mounting Therapy beds access for patient and staff Gym equipment/ basins/ sinks Storage cupboards/ privacy screens
Aids & Carers - assisting with transfers Change of use - rooms may be used for other purposes Equipment - a variety of equipment may be used www.safework.sa.gov.au

Slippery/wet floors; space restrictions; inadequate ventilation; light pooling; visual problems re: patterns/contrast

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PRACTICAL EXAMPLES
2.21 DRESSING ROOM (CLINICAL) DESIGN

Function:, storage of dressings, equipment, treatment preparation.
Workflow and layout

Positioning of cupboards and bench/ sink to assist workflow Sufficient trolley turning space Storage requirements specific to items and equipment
e-Links
www.standards.org.au AS 1428.1 - Design for access and mobility AS 1470 - Health and safety at work principles and practices AS 1940 - The storage and handling of flammable and combustible liquids AS 1680 Interior lighting AS/NZS 3816 - Management of clinical and related wastes
Built in cupboards/ benches/storage Mobile dressing trolley Bench top fridge for medications/ dressings Basin/ sink
Nurses/ carers Equipment type, dimensions, storage and access www.safework.sa.gov.au

Tripping; sharp edges; space restrictions; space restrictions; privacy; temperatures; latex allergy

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PRACTICAL EXAMPLES
2.22 DOCTORS ROOM DESIGN

Function: visiting general practitioners for consulting with residents. The room may be used by allied health practitioners depending on the facility infrastructure and site requirements.
Workflow and layout

Access and storage for wheelchairs and walking frames Location of Patient bed/ desk for ease of consultation Separation of storage requirements (i.e. medical supplies)
e-Links
www.standards.org.au AS 1428.1 - Design for access and mobility AS 1470 - Health and safety at work principles and practices AS 1940 - The storage and handling of flammable and combustible liquids AS/NZS 3816 - Management of clinical and related wastes AS 2500 - Guide to the safe use of electricity in patient care
Desk/chairs and computer Patient bed/ lifting equipment/ steps Storage of medical supplies Storage units/ built ins for paperwork/ reference material
Basins
Specification of basins Ease of use of taps
Use by multiple practitioners/ nurses Equipment - a variety of equipment may be used

Tripping; space restrictions; inadequate ventilation; light pooling

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PRACTICAL EXAMPLES
2.23 TRAINING ROOM DESIGN

Function: in-service education, staff and management meetings, education resources. The training room may be used for other purposes such as an interview room and staff room depending on the facility infrastructure and site requirements.
Workflow and layout

Access and circulation around tables and chairs Consideration of location of fixed audio visual equipment for presentations Consideration of numbers of persons with regard to access & egress
e-Links
Audio visual equipment Tables & chairs ergonomics Storage/ display cupboards Side board Portable whiteboard/ screen
www.standards.org.au AS1428.1 AS 4688 Furniture Fixed height chairs
Multiple use as a meeting/ board room Staff & visitors

Tripping; space restrictions; inadequate ventilation; visual problems re: patterns/contrast; lighting

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PRACTICAL EXAMPLES
2.24 OUTDOOR AREAS DESIGN

The design of the site plan incorporating the facility buildings in relation to the outside areas is important regarding the access to the building, lighting, ventilation, the creation of separate areas for residents, secure gardens, and management/maintenance. The types of vegetation, pathways, access points and screening/shelter are also important to consider in the overall plan.
Flow and layout

Variety of accessible and inaccessible landscape areas Consideration of therapeutic and sensory plantings/ raised garden beds Screening and shelter/ activity areas Minimum access widths for paths around buildings, passing spots, materials Way finding
e-Link
Queensland RACF Design Guidelines www.health.qld.gov.au/cwamb/agedguide/ www.standards.org.au AS 1428.1 - Design for access and mobility AS 1470 - Health and safety at work principles and practices AS 1657 - Fixed platforms, walkways, stairways, and ladders AS1158 - Lighting for roads and public spaces
Furniture and fixtures

Perimeter fencing - security and design Water features - safety features and management Outdoor chairs and tables - heights and ergonomics Garden ornaments & lighting Garden equipment
AS3661 - Slip Resistance of pedestrian surfaces AS1345 - Identification of the contents of pipes, conduits and ducts AS2441 - Installation of Fire hose reels AS 1768 Lightning protection AS 3671 - Traffic noise intrusion in buildings AS 4282 - Control of obtrusive effects of outdoor lighting
Equipment - a variety of equipment may be used
http://www.safework.sa.gov.au/ Crime Prevention Through Environmental Design www.penrithcity.nsw.gov.au/index.asp?id=860

Slippery/wet paths; space restrictions; inadequate shelter; inadequate light; poorly secured; uneven surfaces

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PRINCIPLES OF SAFE DESIGN
3. THE PRINCIPLES AND PROCESS OF SAFE DESIGN

3.1 LEVELS AND AREAS OF RESPONSIBILITY
The principles of safe design were considered in section 1.3 above and, therefore will not be covered in detail here. As an explanation of applying the principles of safe design in a process for the industry to utilise, the principles of safe design can be summarised as: Owners and designers levels of responsibility are equivalent to those of any employer under the OHS legislation and are based on their responsibility to take reasonable steps to eliminate hazards and minimise risks, to the extent to which each party has control. Applying risk management and continuous improvement processes to eliminate hazards to health and safety, or if elimination is not possible, minimising risks from those hazards over the full life cycle of the designed-product. This includes consideration of the risks to workers, residents, volunteers and the public during manufacture / construction, installation, use, maintenance and decommissioning / demolition. Consulting with those affected by their product throughout its life cycle when identifying hazards and developing control strategies over the products life cycle. This is best achieved by involving representatives (through their knowledge and experience) of each life cycle phase during the risk management and design review studies as early as practicable in the development of the project. Provide information and instruction about any risks associated with the product that could not be eliminated through the development of a risk register and feedback process, or its equivalent document that can be developed for an individual life cycle phase.
3.2 THE SAFE DESIGN PROCESS STEPS (Refer to Fig. 1 Page 49)
The safe design process is a collaborative risk management process implemented at the design stage of a product. Such processes can only be effective if the parties to the design, development and ownership of a product adopt the safe design process as a responsibility and documented procedure in their everyday business strategy. Safe design processes are an investment in a products effectiveness, supporting other risk, value or asset management systems used to develop effective and efficacious products. The safe design process, which must be initiated at the product concept design stage to be effective, requires the allocation of responsibilities as well as time and financial resources. It is a process that can inform and educate all stages of a product, including the designer and owner, and lead to better and more innovative design solutions over time. An essential outcome of the safe design process is the production of a residual risk register to record any risk that could not be eliminated. On completion of the safe design process the residual risk register becomes part of the product owners documentation. The owner must then address residual risk at each life cycle stage by informing those involved about the risk and requiring those with control at each phase to implement risk mitigation strategies. Steps in the process are:
3.2.1. The product owner initiates the safe design process through the procurement process
A product owner engages, or arranges the engagement of the designer. It is clear, therefore, that the owner must take responsibility for initiating the overall safe design process by specifying it in the designers engagement brief. The designers brief should specify that the designer: Lead the safe design hazard identification, assessment and control process in consultation with the owner and representatives of the life cycle stages of the proposed product. Undertake redesign of the product, as a result of the risk assessment process, to eliminate, or if elimination is not practicable, minimise risks to health and safety arising from the product. Develop a residual risk register for the product owner to use to mitigate risks over the products life cycle. Specifying responsibilities for the safe design process as part of procurement ensures that the process will occur. The owner should then use the residual risk register to bring identified risks to the attention of those in control at later life cycle stages. There are various ways of doing this: by including an explanation of residual risks in contract
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PRINCIPLES OF SAFE DESIGN specifications and then requiring proposals for mitigation strategies with tenders during later life cycle stages; or by ensuring work procedures developed in a workplace address known risks.
3.2.2. Identify and assemble a risk management team

The designer team leader identifies and engages a risk management team in consultation with the owner. The team must represent knowledge about risks from each stage of the products life cycle and its context to be effective.
3.2.3. Set out the context for the review

The context for examining design safety will depend upon the type of product, how a product may be used, the industry in which it is involved and skill levels of its users. The context of any product must address health and safety risks across the life cycle, and could also include a range of issues affecting the business, e.g. sustainability, future business requirements and long-term business objectives that may also have an impact on health and safety. Guidance on examining the context for risk management is outlined in AS/NZS 4360: Risk Management.
3.2.4. Collate information about risks associated with all stages of the products life cycle.
The design team leader guides the risk management team to collate information about relevant issues based on each members involvement and should include: design industry publications and research, previous injury or risk experience information from each industry sector involved, research reports and industry publications that may address similar products or issues, and OHS Authorities or other safety association reports.
3.2.5. Review the design to identify health and safety risks and redesign options to eliminate or minimise the identified risks
The design team leader guides the risk management team at the design review stage to: identify hazards at each life cycle stage assess risks from the hazards, and identify options for redesign to eliminate or, if elimination is not possible, minimise the risks. Designers must consult with the owner to gain their agreement with some design change aspects, and for the owner to understand any implications of not approving recommended changes.
Example: No. 1 A high noise risk is identified in the drive operation of a proposed product: The owner specified the drive in the original documentation. A designer recommends a quiet, but much higher cost redesign option that eliminates the noise risk. The owner, having been apprised of the risk, and its design solutions, exercises their contractual right, as the owner, to reject the redesign option, include the original drive in the process and accept responsibility for mitigating the risk. The owner intends to install other, minimum cost control devices onsite, and so instructs the designer use the originally specified drive system. The designer is obliged to comply with their contractual obligation to the owner and design the product as specified. The designer can comply with their duty of care for safe design by registering the risk information for the owner to develop mitigation strategies at a later life cycle stage. This demonstrates and records the designers reasonably practicable efforts to comply with risk minimisation by keeping written records of all negotiations or instructions concerning the decision.

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3.2.6. Establish a residual risk register and record details of risks not eliminated
The designer documents any risks not eliminated, their location, exposure circumstances and any suggested downstream risk control strategy. The risk register becomes part of the owners project documentation, providing risk information to those involved at later stages of the products life cycle.
3.2.7. Use the residual risk register to inform life cycle stages of risk applicable to each life cycle stage
The owner must ensure that residual risk information including any suggested mitigation strategies on is passed on to those in control, and to those involved at each life cycle stage of the product to ensure that risks are understood and mitigation strategies implemented. Including risk information in contract specifications, and requiring mitigation strategies to be outlined in tender documents can effectively achieve this. Example No.2 Residual risks that might be present during the construction phase of a building should be highlighted in the construction contract documentation, or safety issues associated with the maintenance of an item of plant can be highlighted in contract documents when engaging a maintenance contractor. Prospective building or maintenance contractors should then be required to submit proposed risk control strategies from their safety plans or work procedures with their tender documentation. Specific materials, processes or equipment necessary as part of a safety solution identified in the design review should be included, in general terms, in the specifications and/or drawings.
3.2.8. Review the process and product to update the register and inform the designer.
Review the safe design process and the product at the post development and post implementation phases. The aim of this step is to record any new risks or risks not identified in the safe design process. Any new risks identified must be assessed and control strategies implemented. Update the risk register and inform the designer of any additional risks discovered or introduced and any additional options for hazard elimination or minimisation that might have been available.

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Fig. 1 Risk Management in the overall context of product delivery

Product owner initiates a project, engages a designer and specifies their involvement in safe design through the engagement brief.
Designer and Owner initiate the safe design process, using design change where possible to eliminate or minimise risks to health and safety. The process must involve representatives of the owner, designer, manufacturer / constructor, user/ occupier, maintenance and disposal functions.
Concept design phase
Designer develops the residual risk register to inform and guide the owner and those involved in life cycle stages through procurement processes and management systems.
Detail design phase
Manufacture / Construct Supply / Fit out / Installation Use / Occupy Maintain Refurbish / Repair Dispose / Demolish
Post delivery / construction & post run in / occupancy review. Owner to provide feedback to the designer, life cycle stages, and to update risk register.

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Fig. 2 The Safe Design Process

1. The product owner initiates safe design through the procurement process Include responsibilities in designers engagement brief 2. The design team leader identifies and assembles the risk management team The team should represent each life cycle stage of the product. A qualified Risk Manager could act for the owner
PRODUCT DESIGN PHASE
3. The owner and risk management team must agree the context for the review The context could include a range of business and/or environmental issues.
4. The risk management team collates information about risks associated with all stages of the products life cycle.
5. The designer leads the risk management team to review the design, identifying health and safety hazards, assessing the risks and identifying redesign options to eliminate or minimise the identified risks. Ref Fig. 3 for Risk Assessments. Ref Fig. 4 for Risk Control. 6. The designer establishes a residual risk register and records details of risks not eliminated. The register becomes part of the owners product documentation.
7.
PRODUCT LIFE CYCLE PHASES
The product owner must use the residual risk register to inform those involved at each life cycle stages of risks applicable to them. Use service specifications and tender documents to provide risk information and request mitigation strategies from prospective tenderers.
As part of the product review process the owner should: review the products performance and risks, And, if necessary: update the residual risk register, inform those involved with manufacture, installation, use and maintenance about any change, and inform the designer of any issue for possible future redesign
8.

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3.3 THE RISK ASSESSMENT PROCESS (Ref: AS/NZS 4360 Risk Management)
The following steps, adapted from AS/NZS 4360: Risk Management provides one method for assessing the risk of hazards identified by the risk management team. The level of risk estimated for each hazard is not an absolute indicator; there is no definitive right or wrong answer to risk assessment. The result is a measure of the view of the participants and serves to indicate two things, (a) a priority for treatment of the risk and (b) an indication of the effort that should be committed to eliminating the hazard. The process described below is suitable for general physical hazards, however for assessment of the health effects of chemical, noise, heat, pressure hazards, other risk assessment processes that take into account dose and dose response effects may be more suitable. (e.g. Enhealths Environmental Health Risk Assessment Guidelines, available at www.health.gov.au/pubhlth/strateg/envhlth/risk/)
Establish the context for Risk Assessment
Hazards Identified by Risk Management Team
Fig. 3 Risk Assessment Phase

1. Estimate the Consequence: If an incident occurred, would the result be: Catastrophic, Major, Moderate, Minor, or Insignificant ? 2. Estimate the Exposure: 1. How many people exposed? 2. How often are people exposed to the hazard? 3. What is the duration of each exposure? Is the likelihood of an incident occurring considered to be: Almost certain, Likely, Possible, Unlikely, Rare?
3. Use the matrix below to determine the Risk Level from the exposure and consequence information above: Is the level of risk: Extreme, High, Moderate or Low? LIKELIHOOD
Almost certain Catastrophic Consequence Major Moderate Minor Insignificant E E E H H
Likely E E H H M
Moderate E E H M L
Unlikely E H M L L
Rare H H M L L

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Fig. 4 Risk Control

4. Use the estimated risk level from Fig. 3.
(above) as a guide to risk treatment effort:
5. Identify redesign options and redesign the situation.
6. Can the hazard be ELIMINATED by
redesign?
7 (a). Yes Hazard ELIMINATED.
Document the solution for future reference Register the residual risk for mitigation by the product owner during the products life cycle.
7. (b) No Risk only MINIMISED
The level of risk determines the input effort to eliminate a hazard. E.g. more time and costs to eliminate an extreme risk level are justifiable, whereas an insignificant risk level might require only a warning label process instruction or monitoring note to a user. Risk may be minimised by minimising exposure. Total exposure to a risk includes a number of components: Risk = No. of people exposed X duration of each exposure X frequency of exposure X concentration (of some risks). Reducing any one or combination of the components may reduce the risk exposure.

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INDUSTRY CASE STUDY 2 Eldercare Incorporated SA Risk Management

Eldercare Inc SA adopted the following approach to risk management across nine sites, as part of a continuous improvement and Occupational Health & Safety initiative: each site identified hazards and associated risks all staff were involved across care, lifestyle and environmental service positions risks were prioritized as either high, medium or low a hazard register was established a hazard status log was established for each site controls were put in place for each risk 3 monthly review commenced to ensure controls are working developed additional safe work practices at each site, which are now being amalgamated into a generic set. Issues identified from previous building projects led to: Design of air handling systems in new kitchens to avoid moisture build up on the floors and possible risk of slips/falls Fall arrest system for working at heights (eg cleaning windows and gutters) Development of checklist to identify any Occupational Health and Safety risks that may occur during the planning, implementation and commissioning stages of any new/renovating projects. To assist with the control of these phases Action Plans are developed prior to commencement of, and if required, during, each phase. Development of register to identify any OHS hazards/ risks at existing sites to eliminate at the design stage for any new buildings/ upgrades. Development of a Working Party for development/redevelopments involving Architects, Project Managers, Executive Directors, OHS Coordinator and staff from all areas to discuss OHS related issues commencing from the planning stage to implementation Eldercare engaged a risk management consultant to assist the organisation in the process. Refer to the obligations under the OHSW Regulations 1995 (S.A.) 1.3.2 and 1.3.3 to conduct hazard identification and risk assessment, and implement control of risk. This requirement encompasses the life cycle impact to all persons associated with a facility; and the subsequent and ongoing requirement to create and maintain a risk register.
Photo 4 Roof anchor bolt
Photo 5 Anchor bolt used for attaching a harness to clean external windows. Thanks to Roofsafe-T-systems Pty Ltd

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3.4 DEVELOPMENT /REFURBISHMENT OF AGED CARE FACILITIES: A SEVEN STEP GUIDE TO SAFE DESIGN
When embarking on a building, product development program we often look to what is to be done and overlook the review of what is currently being done. As part of the development program organisations should look at what policies and procedures they currently have in place to ensure that safe and health of employees and persons in their care. Will these suit the needs of the new facility or are you going to be introducing poor practice into a new site? How can the changes to the building or introduction of a new product improve the practices for health and safety and have these been reflected in the policies and procedures. What training for staff will be required to ensure that they are aware of the changes to practice or policy? The success of any project or facility is reliant on foresight, good planning and attention to detail. Failing to plan is planning to fail. The following steps are a guide to help achieve the desired outcome. No one step stands alone but all are reliant on each other and will be found to overlap in some instances: Step 1: Concept Step 2: Outline Brief, organisation Step 3: Feasibility, research Step 4: Identification, Detailed brief Step 5: Design, documentation Step 6: Construction Step 7: Commissioning
Step 1: Concept
The first step in any endeavour is the idea, the vision of what will be. This requires an individual or group of individuals with foresight and commitment to put the procedures into place to bring the vision into existence. Communicate to members of your organisation the intent to build, refurbish or design. Invite interested persons to participate in the project. Identify what it is you want to achieve and why. Break the project into smaller components and establish focus groups. Utilise the skills, knowledge, experience and expertise of employees who are the users of the end product, or building. Have these groups identify all the key considerations for the project? Invite external specialists or experts to sit on the focus groups or to provide input into outcomes from these groups. Liaise with other organisations that have or are going through similar projects. Share difficulties together to achieve acceptable outcomes. Develop a framework for the vision.
Step 2: Outline brief, organisation

The broad picture of what the aims of the facility or product will be. Where the facility or product will be located or used. When the expected commencement and completion of the project will be. Collating all the information, identified needs, wish lists and vision outcomes that have been gathered through the consultative process with all end users and focus groups. At this stage consultants should be engaged. Architects are able to draw up sketch plans and colour perspectives utilising their information gathered and input from across the organisation and other persons involved in Step one.
Step 3: Feasibility, research

It is at this stage where quantity surveyors need to be engaged to initially assess the feasibility of the original idea. Can the conceptual idea work or is it too expensive? It is at this point where budgets and costs need to be put together and take into consideration the usage and running costs.

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Research should be undertaken for a market analysis of: Current demographics Projected populations Demographic trends User needs Private and public sector involvement or competition Operating personnel Suitable sites Potential user groups Future trends and needs Operation of similar facilities Only when all information is available and research complete should the owner decide whether to proceed with the project, or not. The sole intention should not be to cut costs; it is important to accommodate future needs and avoid creating unsafe or substandard environments, which may lead to additional costs in the long term. It is good business sense and more cost effective to accept the costs early in the design stage rather than to make expensive changes later.
Step 4: Identification, detailed brief

Identify the market groups the facility is aimed at. Look at the future needs changes within the Aged Care Industry and the impact of Ageing in Place. Identify the size and number of rooms and usage specific rooms or areas. Consult with the persons that will be using the areas. Consider space requirements for equipment that needs to be used within the rooms and furniture that residents may wish to have within their rooms. More detailed specification of building and operating requirements Develop a list of desirable features to include and avoid. This is where the work done by the focus groups in identifying safe operating needs and requirements can be utilised. Refine details as required through further discussions with consultants and the focus groups or end users.
Step 5: Design, Documentation

Formal architectural plans and specifications Working drawings Engineering details Final consultations with: representatives of user and wider community groups government bodies interior designers suppliers. Detailed description of functional specifications in order for the facility to fulfil goals of the project such as: size and internal relationships special requirements, temperature, lighting, usage adaptability other special needs Positive design changes may be required to meet changing needs of the community thus updated forecasting is required to meet these design changes.

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Step 6: Construction
Determine suitable form of contract Engage Project manager to monitor project Go to tender and engage builder and or subcontractors experiences with type and size of facility Commence site works Have a detailed progress schedule of works and expected completion and update it monthly Order specialised commodities, furnishings, fit outs early Plan cash flow to avoid interest charges in line with expected work schedule and completion dates.
Step 7: Commissioning
Set a realistic opening date after consulting with builder and architect and then allow a buffer of three weeks. Develop a budget sufficient to launch the facility Selection and hiring of personnel should have been completed during construction thus allowing for manager, key staff and maintenance supervisor to be on site before completion Furniture, equipment etc should be ready for delivery Ensure suppliers provide detailed operating manual on commissioning of equipment Finalise selection and training of staff Address defects and rectify any problem areas Make sure facility does what it is intended to do. These seven steps are a basic starting point to guide one from the start through to the completion of any facility. They are not meant to be conclusive and allow for room and scope for the addition of specific requirements depending on the type of facility and its use. Once commissioning has taken place ongoing maintenance operational checks must be put into practice as well as adequate training. It is important that consultation occurs throughout all stages and steps of the development of the program and that post implementation an evaluation and monitoring program is established. Modification may be required with time as the needs of the community change. Further consultation with experts in various fields may this be required. Feedback from users, the general community and personnel is also important in order to keep the facility running efficiently. Most importantly we must not lose sight of the reasons for building the facility, the needs it must meet and the quality of care it must provide.

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3.5 BUSINESS EFFICIENCY

Safe design processes are virtually identical to other risk management processes such as value management and asset management in that risks in various areas of a business are recognised and mitigated. In their analysis of costs of owning and using buildings(3), Evans et al identified that, in the overall life cycle costs of buildings, significant business operating cost reductions can be achieved through greater investment in the design and construction process, resulting in greater business efficiency. Example No. 3 (from Evans et al) For a commercial building) the whole of life cost ratios were found to be: Design and construction costs Maintenance and building operating costs Business operating costs 1 5 200
During the life of a building, usage, technology and operational aspects change. Complex pressures and problems arise when attempting to improve the productivity within a given building. A design review, in one factory, to examine factors such as noise, temperature fluctuation, lighting and glare, layout and control of the layout by the occupants, resulted productivity improvements of up to 17%. Construction costs for a building are significant and an outcome of the safe design review can be construction cost reductions. Modularisation, standardisation and prefabrication, not only improve health and safety performance in construction by reducing exposure to falls and musculo-skeletal injury, but may also speed up construction, minimising construction time and costs. Loose fit design of plant and equipment in a building can reduce operating costs through simplified maintenance and provide a more flexible re-use of the structure in future.
3.6 SUSTAINABILITY
A major worldwide trend is sustainability. Managing resources and business activity to minimise global impacts of energy usage, greenhouse effects and materials usage through re-use are becoming standard societal demands. Ethical investment is a new cornerstone of business development and sustainability is an economic issue(4). Safe design supports sustainability. Many of the safe design solutions in use improve sustainable developments: minimising the use of volatile organic compounds not only improves the general health of workers but also supports greenhouse initiatives, using prefabricated building modules not only reduces construction workers exposure to falls from heights and musculoskeletal injury, but also reduces materials waste in manufacture and promotes recycling of building components through deconstruction instead of demolition maximising the use of natural lighting and natural ventilation has health and safety benefits for workers through an improved work environment as well as minimising energy consumption and greenhouse effects.
(3)
Evans R. et al The Long Term Costs of owning and using Buildings. The Royal Academy of Engineering, London November 1998. Viewed 24 November 2006 www.raeng.org.uk/news/publications/list/default.htm?TypeID=2
Property council of Australia. Sustainable Development Guide: A roadmap for the Commercial Property Industry. Property Council of Australia 2001
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INDUSTRY CASE STUDY 3 Southern Cross Care (SA) Incorporated Sustainability and Safe Work design
Southern Cross Care (SCC) provides residential care to older people across South Australia. SCC investigated the use of solar panels as part of a residential facility development at Goolwa in the Fleurieu Peninsula. The benefits of solar panels would provide a backup system to mainline electricity supply, as power blackouts have been a common occurrence in the region. The installation of solar panels would also align with the organisations newly developed environmental policy on the use of sustainable energy systems. As part of the design planning process, the issue of cleaning the solar panels and appropriate safety considerations was raised as part of ongoing maintenance for the roof mounted solar panels. Anchor bolts were specified by the Architect/Builder to be mounted on the roof, together with the use of harnesses for maintenance staff and training in their use. Consideration was also given to accessing the roof from internal and external areas. The final design solution and safe work requirements put in place by the organisation are detailed in the pictures/diagrams for mounting the solar panels and anchor bolts. Refer to the obligations under the OHSW Regulations 1995 (S.A.) 1.3.2 and 1.3.3 to conduct hazard identification and risk assessment, and implement control of risk. This requirement encompasses the life cycle impact to all persons associated with a facility; and the subsequent and ongoing requirement to create and maintain a risk register.
Onkaparinga Lodge Hostel Liddell Drive, Huntfield Heights.

Facility is two storeys with a flat steel roof. Recognised during the construction planning that it would be necessary to access the roof for maintenance of the air-conditioners and for window cleaning and other maintenance tasks. A pull down ladder was designed and installed and anchor bolts fitted for use of fall arrestor lines. Further safeguards included the installation of walkways over the roof steels sheets. Refer to Photos 6 -10
Photo 6
Photo 7
Photo 8
Photo 9
Photo 10

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3.7 LIFE CYCLE STAGES OF VARIOUS PRODUCT TYPES
Table 1: Life cycle stages of various product types (5)

Phase Design/development Description Planning Concept Research & development General design Detailed design Approval Technical specifications Manufacture Construction Assembly Testing & evaluation Packaging Labelling Storage Packaging Labelling Marketing Distribution Sale Hire or lease Transport Installation Erection Commissioning Occupation Operation Consumption Cleaning Maintenance Servicing Adjustment Inspection Repair Modification Refurbishment Renovation/extension Recycling Resale (direct, auction, dealer) Decommissioning Dismantling Plant Building Substance System
Manufacture
Import/supply Life Cycle Phases
Set up
Use Maintenance
Further use
End of use
(5)
Modified, based on: Bluff L, Occupational Health and Safety in the Design and Manufacture of Plant, unpublished draft of PhD research - 2002

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APPENDICES and REFERENCES
APPENDICES

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APPENDIX A
TABLE 1: GLOSSARY OF OHS AND DESIGN RELATED TERMS
Any party with influence over the specifications of the designed-product (including, but not limited to the designer, the client or commissioning agent, the financier, the manufacturer, supplier, purchaser, installer, user, insurer, importer, erector, maintainer and regulator, and employees of these agents). The process of bringing together innovation, aesthetics, and functionality to plan and create a product, process or system to meet the artistic, industrial or performance requirement of an individual or group. The design process involves a series of activities where an idea is conceived, shaped, developed, produced and then acted upon to produce a designed product. It also includes any subsequent alteration of a designed product (redesign or retrofit). The stages of the design process include: the concept design phase which considers preliminary design options determining the best preliminary design by assessing design options against product specifications Design process research and development, feasibility and risk management (including OHS risks). the detailed design phase which develops the selected design to its final state. This includes research and development, feasibility studies, concept and detail design, technical and functional specifications, plans and drawings, operational systems, construct/manufacture options and detailed quantities, cost and risk analysis (including analysis of OHS risks). The item to be designed, including a built environment, structure, an item of plant or equipment, chemical, work system or process; or any other physical attribute or system associated with either the work or its interface with people. A source or situation with a potential for harm in terms of human injury or ill health, damage to property, environment or a combination of these. The process of identifying potential causes of injury or illness. Different methods may be used to identify hazards including observation; consultation with workers, clients or other users; trial of models or prototypes; review of technical standards and other information sources; monitoring and measurement. A list of control measures, in priority order, which should be used to eliminate OHS hazards or minimise exposure to OHS risks. Application of the hierarchy of control considers, as the first priority, whether a risk can be eliminated. Where this is not practicable, the second priority is to consider substitution. If substitution is not practicable, the third priority is to use engineering controls. Lower order controls are then considered, eg, administrative procedures and, lastly the use of personal protective clothing or equipment. This hierarchy is applied, until a control measure or combination of control measures are identified to eliminate the OHS hazard or minimise the OHS risk.
Decision maker
Design
Designed-product
Hazard
Hazard identification
Hierarchy of controls

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APPENDICES and REFERENCES Cont./ Table 1: Glossary of OHS and design related terms All phases in the life of a product. Specific phases depend on the type of product but may include design, development, manufacture, construction, assembly, import, supply, distribution, sale, hire, lease, storage, transport, installation, erection, commissioning, use or operation, consumption, maintenance, servicing, cleaning, adjustment, inspection, repair, modification, refurbishment, renovation, recycling, resale, decommissioning, dismantling, demolition, discontinuance or disposal. Risk, in relation to any hazard, means the probability and consequences of injury, illness or damage arising from exposure to the hazard(s). Plant includes any machinery, equipment (including scaffolding), appliance, implement or tool and any component or fitting thereof or accessory thereto. The chance of something happening that will have an impact upon objectives, measured in terms of probability and consequences (see OHS risk above). The process of analysing the probability and consequences of injury or illness arising from exposure to identified hazards. An appraisal of the degree of undesirability of the various risks after they have been quantified, with consideration to the various factors and tradeoffs influencing risk acceptability. Risk that remains after the application of controls, and other risk reducing methods or techniques. Safe design is a design process that eliminates hazards, or minimises potential risk to health and safety by involving decision makers and considering OHS risks throughout the life cycle of the designed-product. A safe design approach will generate a design option that eliminates OHS hazards or minimises the risks to those that make the product, and those that use it.
Life cycle
OHS risk
Plant
Risk
Risk assessment
Risk evaluation
Residual risk
Safe design

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APPENDIX B
Aged Care Industry Generic Hazards Register
www.safeworksa.sa.gov.au Industry > SAfer Industries > Aged Care > Resources
APPENDIX C
Pre purchase criteria for equipment and products
www.workcover.vic.gov.au/vwa/home.nsf/pages/so_aged > pre-purchase guidelines
APPENDIX D
Type, frequency, nature, and cost of injuries and illness in Aged Care
www.safeworksa.sa.gov.au Industry > SAfer Industries > Aged Care > Resources

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REFERENCES
Australian Standards relating to Safe Design for Aged Care Facilities
Australian Standard AS 1428 AS 4299 AS 3661 AS 1668 AS 1680 AS 1158 AS 4282 AS 3666 AS 3500 AS 1345 AS 2441 AS 4146 AS 3000 AS 3008 AS 3009 AS 3010 AS 3013 AS 3080 AS 1768 AS 1020 AS 4688 AS 4438 AS 3590 AS/NZS 2107 AS/NZS 3816 HB 260 AS 2293 AS 3811 AS 1670 AS 2118 AS 2419 AS 2441 AS 2444 Topic Design for access and mobility Adaptable Housing Slip Resistance of pedestrian surfaces The use of ventilation and air conditioning in Buildings Interior Lighting Lighting for roads and public spaces Control of obtrusive effects of outdoor lighting Air handling & Water Systems of Buildings Plumbing and Drainage Identification of the contents of pipes, conduits and ducts Installation of Fire hose reels Laundry Practice Electrical Installations Electrical Installations Selection of Cables Electrical Installations- Emergency power supplies in Hospitals Electrical Installations - Generating Electrical Installations Classification of the fire and mechanical performance of wiring system elements Telecommunications installations Lightning protection The control of undesirable static electricity Furniture Fixed height chairs Height adjustable swivel chairs Screen based workstations Acoustics Recommended design sound levels and reverberation times in building interiors Management of clinical and related wastes Hospital acquired infections Engineering down the risk Emergency escape lighting and access signs Hard-wired patient alarm systems Fire detection, warning, control and intercom systems Automatic fire sprinkler systems Fire hydrant installations Installation of fire hose reels Portable fire extinguishers and fire blankets

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APPENDICES and REFERENCES Cont./ Australian Standards relating to Safe Design for Aged Care Facilities Topic Guide to the safe use of electricity in patient care Emergency control organization and procedures for buildings Safety glazing materials in buildings Security for health care facilities Health and safety at work principles and practices The storage and handling of flammable and combustible liquids Flusher/sanitizer for bed pans and urine bottles Traffic noise intrusion in buildings Fixed platforms, walkways, stairways, and ladders
Australian Standard AS 2500 AS 3745 AS/NZS 2208 AS 4485 AS 1470 AS 1940 AS 2437 AS 3671 AS 1657

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INTRODUCTION

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

Safer Aged Care Safe Design Steering Committee

Additional acknowledgements to:

Design and produced by:

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

HOW TO USE THESE GUIDELINES:

Guide to the Safe Design of Aged Care Facilities

Guidance on the Principles of Safe Design at Work.

Refer to Principles of Universal Design

Refer to Considerations for Safe Design

Consider the Safe Design Process Steps: 1 8

Refer to Practical Examples: 1 24

Refer to Links for detailed information

Input into the design process

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

1.1 WHY SAFE DESIGN?

1.2 WHAT IS SAFE DESIGN?

1.3 UNIVERSAL DESIGN PRINCIPLES

Australian Safety and Compensation Council, viewed 24 November 2006 www.ascc.gov.au/ascc/HealthSafety/SafeDesign/Understanding/Whatissafedesign.htm

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

For further information refer to:

1.4 CONSIDERATIONS FOR SAFE DESIGN

1.4.2 There is systematic hazard identification and risk evaluation

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

1.4.5 A sustainable designed-product result

1.5 REASONABLY PRACTICABLE

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

1.6 OHS RESPONSIBILITIES FOR DESIGN

Section 24 - Duties of manufacturers etc

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

1.8 GLOBAL DIRECTIONS

For further information refer to:

1.9 AGEING IN PLACE AND EMERGING ISSUES

For further information and links refer to:

1.10 DESIGN FOR DEMENTIA

For further information and links on dementia refer to:

1.11 DESIGN FOR PALLIATIVE CARE

For further information and links on Palliative Care refer to:

1.12 OVERHEAD LIFTERS

1.13 DESIGN FOR DISASSEMBLY

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

For further information and links refer to:

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

2.0 COMMON REQUIREMENTS FOR ALL ROOM FUNCTIONS

Building Code of Australia (BCA) www.abcb.gov.au www.hermanmiller.com ergonomics

Lighting / ventilation / noise

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

2.0 Common Requirements for all Room Functions (Cont./)

Safety and Environmental systems

www.safework.sa.gov.au then Legislation

www.workcover.vic.gov.au/vwa/home.nsf/pages/so_ag ed pre-purchase guidelines www.dirp.qld.gov.au/pdf/whs/plant_code2005.pdf Plant Code of Practice

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

GUIDE TO THE SAFE DESIGN OF AGED CARE FACILITIES

2.1 EN SUITE/BATHROOM DESIGN

Workflow and Layout