Types of Care Home Refurbishment in the UK

Not all care home refurbishments are the same. The scope, trigger, urgency, and design brief all vary depending on what’s driving the project. Understanding which type of refurbishment applies to your situation is the first step to scoping it correctly and budgeting for it accurately. These are the six main types of care home refurbishment we deliver, along with the situations in which each applies.

Compliance Led Refurbishment

Triggered by a CQC Inspection report identifying Non-Compliance Issues relating to the environment of your premises, a Regulation 15 Failure, and enforcement action

This is usually the most URGENT type of refurbishment. This occurs when a CQC Inspection identifies aspects of your physical environment as being unsafe/inadequate/not meeting the fundamental standards. Under Regulation 15 of the Health and Social Care Act 2008, Premises & Equipment MUST be suitable for their intended purpose, properly maintained AND meet the needs of residents. In such cases, you will need to take corrective action promptly after receiving a Regulation 15 Notice from the CQC.
Typically, compliance-led refurbishments focus on addressing specific failings identified during inspections. Examples include: Inaccessible Bathrooms/En-Suites/Wet Rooms that cannot be used by residents with mobility needs; Fire Doors that do not meet the Specification set out in HTM 60; Corridors lacking Handrails; Surfaces that provide inadequate infection control; Lighting Conditions that create Safety Risks. In these cases, the Inspection Report becomes the Design Brief.
We support Care Home Operators who have received 'Requires Improvement' or 'Inadequate' Ratings following CQC inspections related to their Environment. We use the Inspection Report to identify the aspects of your physical environment that are driving your Rating, and to develop a Prioritised Plan of Action to address them in order of Regulatory Impact.
• Typical Triggers: CQC Inspection Reports; Regulation 15 Notices; Local Authority Enforcement Action
• Common Scope: Bathroom & Wet Room Upgrades; Replacement of Fire Doors; Installation of Handrails; Flooring; Infection Control Surfaces; Lighting
• Programme: Typically delivered within an urgent timeframe (typically 4–12 weeks, depending upon Scale)
• We Can attend your re-inspection as the contractor of record to confirm that all works have been completed to standard.

Wet Room and Bathroom Refurbishment 

A bathroom/wet room refurbishment is the area of a care home that ages the quickest, takes the greatest amount of wear & tear, and is scrutinised more than any other area by CQC Inspectors. The poor condition of many care home bathrooms is a major reason why so many care homes are given 'Requires Improvement' status for their environment. Families looking for a suitable care home often have 'bathroom facilities' high up on their list of priorities when selecting a home. Equally, residents in care homes place great emphasis on the quality of their own bathrooms.

Care Home wet room refurbishments differ significantly from residential bathroom refurbishments. In addition to meeting all relevant Part M Accessibility Standards (e.g., level entry), we must also ensure our designs allow for profiling beds and/or ceiling hoists to be installed whilst the resident's personal care is taking place. Non-porous antimicrobial surface materials must also withstand clinical-grade cleaning and comply with relevant drainage, ventilation, and thermostatic control specifications. We provide full bathroom and wet room refurbishment services, including the design and installation of fully accessible bathrooms/wet rooms in occupied Care Homes. Where possible, we work on each room/floor of the building, minimising disruption to your operation. Residents will always have unrestricted access to toilet/bathroom facilities.

• All wet rooms and bathrooms are designed to be accessible with barrier-free entry and anti-slip rated floors
• Walls are reinforced for future grab rail/hoist track installations
• Shower/Bath controls are thermostatically controlled to prevent scalding
• Coved skirting/Sealed surfaces for infection control
• Extract ventilation sufficient enough to deal with moisture reduction/Legionella prevention
• Contrasting colour sanitary ware for Dementia residents
• Average Programme time: 2-4 Days per room, depending upon the location and relocation of residents within the home.

Fire Safety Refurbishment

The following three items can also trigger a fire safety refurbishment:

* A failing fire risk assessment due to the age or condition of the building
* Changes in the population you support, such as increasing the dependency level of residents requiring a new evacuation procedure
* Upgrades to make the existing fire safety measures meet current regulations
* The requirement to install a compulsory sprinkler system prior to obtaining CQC registration.

A fire safety refurbishment in this context is more technical than it appears. Fire compartmentation is essentially about upgrading walls, floors, and ceiling voids to keep fire within them for a certain amount of time. Fire doors meeting HTM 60 specifications require proper frame installation, sealing and documentation for future inspections; we collaborate with qualified fire engineers and Building Control to create and approve fire strategies in care facilities.

• Compartmenting: upgrading walls, floors and ceiling voids to contain fire spread
• Replacement of HTM 60 compliant fire doors, including provision of frames, seals and self-closers
• Design and installation of sprinkler systems in occupied buildings
• Upgrade of emergency lighting to current BS 5266 standards
• Assessment of lifts to be used for evacuation
• Creation of refuge areas and signage
• Coordinated with your fire risk assessor and Building Control.

Full Phased Refurbishment

A total project to deliver an entire property refurbishment, with the home remaining open for occupation. Phase Refurbishment is the largest form of refurbishment project. Typically, all areas of the home will be refurbished, such as bedrooms & bathrooms, common areas, kitchen facilities, mechanical & electrical services, and external areas. The key distinction is how the refurbishment is carried out. Instead of fixing specific parts of the building, we transform it.

The main advantage of the phased method is that the home remains operational throughout. Care homes cannot shut down, and residents cannot be relocated during the project. As a result, the work is split into sequential phases, i.e. one wing, one floor or one section at a time. When a phase is completed, residents are moved into the new area, and the remainder of the home continues without interruption. This process will continue until all of the homes have been refurbished.

Typically, these large-scale refurbishments take anywhere from six to eighteen months to complete. These projects always require a wide variety of skilled tradesmen, e.g. builders, electricians, plumbers, tilers, decorators, etc. All of which will be working together under the direction of a single Project Manager. As they understand what makes a live care environment tick.

From a commercial perspective, there may be no larger refurbishment than a full refurbishment. Provided the refurbishment is executed properly, a high-quality refurbishment can improve a home from 'Requires Improvement' to 'Good' and 'Outstanding'. In addition, by improving the overall quality of accommodation available in a home, operators can expect increased occupancy levels, allowing them to charge higher fees for their services and also retain their employees. Many care home providers have reported an improvement in private enquiries about the home in question, up to three (3) to six (6) months post-completion.

• Bedroom refurbishment including installation of wet rooms; flooring; lighting; furniture etc.
• Design and refurbishment of all communal areas: lounges, dining rooms, activity areas, corridors, etc.
• Renovation of kitchen and commercial catering facilities to HACCP-compliant standards
• Replacement of mechanical and electrical services: heating systems; ventilation systems; nurse call systems; door entry systems etc.
• External works: car parks; entrances; gardens; sensory areas etc.
• A full Programme Management service provided by a designated Project Manager

Partial or Targeted Refurbishment

Refurbishing parts of the property (or part of it) as opposed to all of it, often due to operator budgets or timelines
It's simply not true that every care home requires a complete refurbishment. Some may find that their entire building is in fairly good condition overall, but one or two areas are causing problems; perhaps a family member notices how tired and worn out the lounge appears immediately upon arrival, there may be some issues with the kitchen's ability to maintain proper hygienic practices, or the corridors may not be easily accessible by wheelchair users. The garden has likely gone untouched for years.
A partial refurbishment is typically used by small care home owners and by those who have an overall compliance rating but wish to enhance certain areas of their property to support occupancy and/or improve CQC ratings. A partial refurbishment is a great option if you're working within budget constraints. We assist our clients with prioritising which items will provide the greatest impact to begin with and develop long-term programs for each item that follows.
One advantage of a targeted approach is its speed and minimal disruption. A single lounge refurbishment, garden redesign, etc., can be completed in weeks compared to a program of months. As a result of the reduced amount of dislocation caused by the partial refurbishment process, residents will see much less disruption, and they'll be able to appreciate the positive changes made to these specific areas quickly.

• Upgrades to individual rooms or areas: lounges, dining rooms, activity rooms, sensory rooms, etc.
• Improvements to outdoor spaces/gardens: walkways/pathways, raised planters/beds, seating, covered/sheltered areas
• Upgrades to corridors: wider doorways, handrails, flooring, lighting, signage/directions (wayfinding)
• Bedroom upgrade programs: upgrading 5-10 bedrooms at a time over the course of months.
• Kitchen upgrades: kitchen ventilation, kitchen flooring, kitchen surface materials/equipment -- without full kitchen renovation
• Ideal for: Operators with clear priorities, limited windows of opportunity or phased budgeting.

Post-Acquisition Refurbishment

Refurbishing a newly purchased care home, whether prior to or post-occupancy, is typically the most financially rewarding investment opportunity within the industry

As a rule of thumb, when buying a care home that requires renovation/upgrade, the purchaser has likely factored the property's current state into their purchase price (the 'as-is' condition). It is also typical that the purchaser plans to utilise this upgrade/refurbishment to enhance CQC ratings; create an improved product to attract higher paying residents/families; thereby increasing occupancy and ultimately increasing revenue.

When done properly, Post-Acquisition Refurbishment is among the highest-returning investments in the industry.

However, these projects are usually accomplished under tight deadlines. Purchasers wish to either rapidly complete renovations in order to open/re-open the facility in a timely manner, market available rooms to prospective residents and families, and generate cash flow. Due to the urgency of the project schedule, there is little margin for error. Poor sequence management, missed materials, and/or subcontractors without experience working in a live-care setting can cause significant delays.

We assist both purchasers/buyers who have acquired a care home for opening and/or owners/operators who have recently closed on a purchase and now desire to initiate immediate renovation. We can begin assessing the home upon agreement of sale, allowing the program to be developed prior to closing. When a purchaser acquires a vacant care home, we can often provide greater flexibility in terms of moving forward. Rather than phase construction around resident presence, we can work simultaneously throughout the entire building. Conversely, if a purchaser acquires a care home that has residents currently occupying the space, we implement our standard protocol of phased construction while minimising disruptions to the residents/staff.

• Assessment commences upon survey/acquisition
• Program structured based on the target opening/reopening date
• Vacant Possession: Faster overall building delivery
• Going Concern: Phased delivery around existing residents/staff
• Highest Priority Scope: Areas most visible to potential residents/families & those identified in the Pre-Acquisition Condition Report
• Support with CQC Registration: We develop the required documentation for inspection.

Which Type of Refurbishment Do You Need?

You likely understand broadly what will lead to your care home refurbishment; however, typically, you would like to establish your program, budget and scope prior to moving forward. Typically, your "trigger" (CQC report, recent acquisition or a particular area that has failed inspection), will dictate the type of refurbishment that you require, whereas your building and budget will ultimately dictate how you go about it.
A good first step is a site visit. We will come to your care home and inspect your care home facilities and buildings based upon current CQC guidelines and care home facility design standards. We will also meet with your management staff and care team members to assist them in establishing what they need and when and at what cost. There are NO CHARGES for the above referenced site visit.