Resources for Care Home Garden Design
Here you’ll find all our articles, blogs and videos about our work helping to create actively and meaningfully used outside spaces for residents living in care settings. Below, we have grouped them into four themes to make it easier to find the topic you want to read about.
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Going Outside More, Handy Tips, Tackling Myths
This handout contains five easy hints and tips to support people living with dementia to continue to step into the garden. Perfect for carers whether living at home or in a care home.
Live radio interview with Gina Awad ‘Living better with Dementia’, Phonic FM – 31st May 2025
An exploration with Debbie Carroll around her research into what it takes to create actively used dementia gardens and helping carers keep the connection to the outside alive for people living with dementia.
Uniquely this interview gave the chance to share two great songs that reflect our mission and desire to ensure care home gardens are freely accessible to their residents. Take a listen to what she chose:
Interview 38min long, Song 1 – 16:57mins, Song 2 – 35:00mins
Age UK Salford Empowered Conversation – 28 February 2024
In this webinar, Debbie shares the research undertaken by Step Change Design which was formed to share the findings of an extensive research project into understanding what makes care home gardens used more actively, particularly for dementia care homes. Debbie walks us through the findings from the research, shares some great examples and offers up some easy steps to getting people into the garden. “The key findings identified that the care culture, the practices, attitudes and values of a setting, related to the outside will influence how actively used the garden will be. Higher performing, person and relationship-centred care practices were more naturally able to engage meaningfully outside. This study identified the need for both the Care Home and Garden Design sectors to consider a Setting’s cultural practices from the outset when taking steps to improve their resident’s interaction with the garden and prior to undertaking a new care home garden design’
58mins, 1st 26mins an overview presentation of our research, findings and applying them to care home gardens and those caring at home, particularly for people living with dementia, this followed by a Q & A session
YouTube https://youtu.be/CjEGheN6RQQ?si=gT71NrDX5KB9M_cD
NAPA Living Life Magazine – Summer 2018 – Promoting the Interconnectedness of indoors and outdoors in care settings (PDF 3.5Mb)
Lots of prompts and ideas to help make your care setting more outdoors-focused and ready to make the most of all the fantastic opportunities to engage actively and meaningfully with your outside spaces.
NAPA Living Life Magazine – Autumn 2017 – Mythbusting and explaining care culture (PDF 6MB)
An explanation of care culture and ‘myth-busting’: tackling the most commonly stated reasons for not using the outdoors more. Lots of practical and helpful tips and guidance on how to use the outside space more actively and more often.
NAPA Living Life – Spring 2015 The Checklist Tool (PDF 1Mb)
We describe our sense-checking and money-saving tool, the Checklist, to ensure activities, features or elements planned for the garden will be appropriate and cost-effective, particularly for residents living with dementia.
NAPA Living Life – Autumn 2014 Top Ten Tips for Care Staff (PDF 1.86Mb)
We explore our Top 10 insights and tips to help care settings overcome common obstacles hindering better engagement with the garden for residents in care settings, and particularly for those living with dementia.
Our Research, Care Culture & Care Management Practices
The Dementia Dialogues Podcast – 23 February 2025
‘ Why don’t we go into the garden?‘
Discover the incredible benefits of stepping outside, especially for those living with dementia. Debbie Carroll speaks with Natalie Carter, as a part of her ‘Dementia Dialogues’ podcast series, and shares powerful stories and surprising research findings that highlight how nature can uplift spirits and foster connections and support people living with dementia to continue to step into the garden freely whether living in their own home or in a care home. Learn practical tips and inspiring insights that could transform your relationship with the great outdoors!
45mins https://podcasts.apple.com/gb/podcast/the-dementia-dialogues/id1778036642
Take a Breath in the great outdoors – May 7 2024
Dementia Community Webinar delivered with Gordon Malcolm, Dementia Adventure
‘The science tells us that getting outside is good for us, and in particular for people living with dementia, yet this doesn’t always feel easy. Gordon Malcom, Dementia Adventure, and Debbie Carroll, Step Change Design, come together to share how to overcome the often subtle barriers to getting outside so you can reap the rewards of enjoying nature and your gardens more.’
1hr. SCD slot 16mins in, 15min short overview. https://www.youtube.com/watch?v=8KVMMraf3xU
Journal of Dementia Care – November/December 2022 – Article is on pages 32-36 (PDF 2.6Mb)
Our 3rd article rounding off the sharing of our research through this Journal. In this article we provide the insights of our research findings, and an overview of our latest publication, through the eyes of the role of garden designers. We explore how we can support care settings in a new way we call ‘Relationship-Centred Design’ to create more actively used care setting gardens.
Journal of Dementia Care – September/October 2019 (PDF 2.6Mb)
In this article we explain what we did with the quantitative data we had amassed from our research project in 2013 and how it evolved into an A3 Infographic Poster. We include anecdotes from the diary records and provide statistical data on what hinders greater engagement with the outside space for residents in care settings and some easy-to-achieve steps to take to extend garden visits.
Care Management Matters – December 2017 (PDF 1.8Mb)
An in-depth article that explains what we mean by ‘culture change’, the challenge that this presents for care sector managers and how our Care Culture Map tool aids the care setting on its culture change journey towards greater engagement levels with the outside space.
Care Roadshows 2017 website blog – series of 5 articles (PDF 900kB)
A series of short articles about our research, why we focus on care culture as the key to understanding engagement levels with the outside space and what to consider before making physical changes or employing a Garden Designer or other outside specialist.
Journal for Dementia Care – Spring 2015 article “Why Don’t We Go Into The Garden?” (PDF 6Mb)
The equivalent of our academic paper on the research project we carried out to understand why care setting gardens are not more actively used. It covers the methodology we used and the unexpected journey we went on that revealed the key findings and what this means for care settings and designers and other outside specialists.
Garden Design & Landscape Architecture Considerations
A new garden – What happens after the novelty period? – May 2026
Publication: The Care Home Environment
Understanding care culture is crucial to successful outside space design that creates enduring and meaningful engagement with a care environments garden areas. In the same way designers need to understand soil science for plant selection so understanding their care client’s organisational practice is as key for providing the right and timely design support if the spaces we create are to be used long after we have left.
Webinar: Australian Aged Care Design Principles series – 30 April 2026
Principle 3:Access the outdoors
This webinar is one in an 8 part series exploring the Australian Governments ‘Aged Care Design Principles and Guidance’. This rich series covers all aspect of aged care design and in this one it explores’ Principle 3 – Access the Outdoors’, highlighting the importance of nature, fresh air and outdoor movement for wellbeing. I was excited to be part of this panel style webinar hosted by Nick Seeman Environments Specialist and alongside Nathan Clausen, Landscape Architect and Dennis Frost, Dementia Champion.
Webinar series: https://dta.com.au/designing-for-better-living/
Australian ‘Aged Care Design Principles & Guidance’ – https://www.health.gov.au/resources/publications/national-aged-care-design-principles-and-guidelines?language=en
1 hour, Step Change Design section is at 26-41mins
Accessible design – why not use the garden? – 5 August 2024
A Roots & All Podcast with Sarah Wilson
‘This episode Debbie shares her experience in designing for care homes and other health settings for residents with dementia. Her work in these surroundings prompted her to question why these gardens were not more actively used even when they were designed to the latest design guidance. Along with her fellow designer Mark Rendell they researched what hindered engagement with the garden, in particular for people living with dementia.’
30min long
A Fresh look at your outside spaces – 9 July 2024
Housing LIN (Learning & Ideas Network) Webinar/panel session
‘The Dementia & Housing Working Group (DHWG) is excited to use this HAPPI Hour to launch the inaugural webinar in a quarterly series focused on housing and dementia. This webinar addresses a range of topics, providing easy and actionable guidance to help organisations gather insights and implement them effectively. It emphasises the importance of making small changes that can make a real difference, rather than significant capital investments. We dedicate this webinar to the late, great, writer and activist Wendy Mitchell. Diagnosed with dementia and spending years documenting her experience, we will be forever in her debt as she won hearts and minds by advocating for living positively with dementia.’ Step Change Design covers the areas to investigate to help use the space you already have or to support what may need changing’
YouTube link https://www.youtube.com/watch?v=ckptTeckiMg
1:40mins, Step Change Design’s presentation is 33:19min, 8min long
Care Home Environment Magazine – October 2022 (PDF 1.8Mb)
An in-depth article explaining the role of care culture on actively used care setting gardens and how this impacts how garden designers may need to deliver their support. The key principles of a new way for care settings and designers to work together, ‘Relationship-Centred Design, is explored with key principles outlined.
Landscape Show 2017 – series of 5 short articles (PDF 600kB)
A series of short articles posing some challenging questions for Garden Designers and Landscape Architects when working with care settings to ensure their support is cost-effective and leads to actively and meaningfully used outdoor spaces.
Landscape Show 2016 Preview magazine – series of 5 short articles (PDF 900kB)
We address the question, “Why aren’t care home gardens used more actively?” to garden designers and outside specialists and describe key insights from our research project that can help answer this question and avoid creating under-used outdoor spaces around care settings.
The Horticulturist magazine – Autumn 2016 – article (PDF 4Mb)
A long article that goes into detail about key elements of our research project and how we needed to address our beliefs and attitudes about our work as designers and how this led to the breakthrough in our understanding about why care setting gardens are not more actively used even when they meet the latest design guidance. Includes detailed Top 10 points for garden designers and other outside specialists to consider when working with care clients.
The Care Home Environment – Vol. 1 Issue 2 Nov 16 (PDF 6Mb)
In this long article, we explain how we discovered the link between care culture and active use of the outside space around care settings and how this informed our decision to create a ‘Map’ tool to help care settings address their care cultures and activate their outside spaces.
Garden Design Journal December 2015 article – Relationship-Centred Design (PDF 1.2Mb)
A challenging and thought-provoking article for our designer peers calling for a new way to work with our care sector clients, and introducing our new approach we call ‘Relationship-Centred Design’ (RCD)
Step Change Design – Information about our work
Research methodology review poster – 9 December 2024
‘This Poster was first displayed at the UK Dementia Congress 2024 and is a reflective of our 10 year long unique research journey versus the more traditional academic route. We share our highs and lows to our approach and some insights from other key contacts we encountered along the way’
Newsletters
NAPA Award Win January 2026 special Newsletter
July 2024, Celebrating 10 years