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Designing Horatio's Garden: a green haven for spinal patients in memory of Horatio Chapple

Head gardener Imogen Jackson tends a border
Head gardener Imogen Jackson tends a border Credit: Andrew Fox

There is a lot of talk about the health-giving properties of gardening, but to see it in action is truly brilliant. When Dr Olivia Chapple asked me to design the landscape scheme for the fourth “Horatio’s Garden” at the Midland Centre for Spinal Injuries in Oswestry – I had no doubts. It was an honour. Unity (my daughter, who works with me) and I both leapt at the chance.

We were both aware of the history of the charity. It is named after Horatio Chapple, Olivia’s son, who as a schoolboy wanted to be a doctor and volunteered at the spinal centre in Salisbury where his father, David (a spinal surgeon), worked. Horatio carried out a survey among patients to find out how their lives in hospital could be improved. Patients with severe spinal injuries often face six months or more in hospital, adjusting to the fact that their life has been turned upside down.

Surprisingly, these injuries are not necessarily caused by risky pursuits – often they are the result of falling off a low kerb or something equally mundane that can happen to anyone at any time.

In his survey, Horatio discovered that a garden, a tranquil space away from talk of catheters and bedpans, would help give patients hope, peace and pleasure. Tragically, Horatio’s life was cut short at 17, when his camp was attacked by a polar bear during a school expedition to the Svalbard Islands in the Arctic Ocean in 2011. His legacy, through the work of Olivia and her husband, ensures that Horatio’s enlightened survey has initiated the process of creating uplifting garden spaces in all of the UK’s 11 spinal centres.

Early ideas

When we first visited the site just before Christmas in 2016, it was a wet, cold winter’s day. The site looked quite small and full of bollards. The dominant features were the road that bordered the site and the housing opposite. We rapidly drew up a design for a discussion with the patients, staff and the hospital administrators. This included screening and sheltering the site using instant yew hedging from Elveden Estate, which gave us a generous deal. A greenhouse with an extended canopy for covered space was essential, so gardening could take place whatever the weather. Griffin Glasshouses was generous as well. A row of arbours, a raised rill to bring in water and wildlife and a mini-woodland of river birch featured, too.

Olivia Chapple, Rebecca Warren and Bunny Guinness with patient Keith Santon in the 
new Horatio’s Garden, Oswestry, Shropshire

Raised beds of various heights and sizes, designed to allow patients to get hands-on, and a big events space for cake sales, music concerts and art therapy were also included. We also added a small arbour to house chickens (so mesmerising to watch) and a wood- burning stove, though we thought these might well not be feasible. What we had not expected was that the chief executive of the hospital, Mark Brandreth, would be so accommodating. He managed to allow just about everything and the words “red tape” never passed his lips. The chickens did sadly bite the dust, but for other reasons.

Sister Rebecca Warren is the ward manager at Oswestry. Becky and her team gave us good ideas during the consultations. She suggested that a practice area for new wheelchair users would be good, with dropped kerbs of different heights, different gradient slopes and a gate to open and shut.

The initial site manager, Paul Leon from Read Construction, was on side – he is a former patient of the unit (after a skydiving accident) and is due back for more spinal surgery in the next two years. “I will definitely make good use of the garden!” he said.

the garden was built around the needs of wheelchair users, with raised beds, wide paths and a greenhouse for rainy days Credit:  Andrew Fox

When we came to the soft landscaping, all the patients started to become more interested. From their windows they had watched the diggers, cranes, mud and mayhem, and now they could see the light. Butler Landscapes did the planting and remained calm through many delays – and the unwelcome arrival of hot, dry weather just as all the plants appeared.

Positive effects

Chatting to Becky once the garden was finished was enlightening. One patient who came from another hospital had not been outside for seven weeks, but on arrival at Oswestry was outside after two days and “thought it was the best thing ever”. Becky said the patients were far happier and less frustrated, there was less bell-ringing and many were outside more than they ever had been before in their lives.

Inside, she explained, they were afraid of being watched getting to grips with their wheelchairs and so just parked them in their bed spaces. Outside, they felt less inhibited.

The mini arbours we created from “branched” metal work are big enough to take a hospital bed, so occupants can have private chats with loved ones. This is rarely possible in a ward. One day, apparently, there were eight beds in the garden, but it did not feel crowded.

Horatio's Garden within the grounds of Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry Credit:  Andrew Fox

Becky said now you could hear visiting children playing in the play area and elsewhere. Before, they used to roll around on the floor of the ward and get bored and hate visiting.

I had not anticipated what a difference the garden would make to the staff. They had asked for French windows and a paved area by their poky staff room – this was easy to accommodate. But they now work outside when they can, doing paperwork, feeding and exercising patients and giving therapy in secluded spaces. It has really improved their working environment.

Every Horatio’s Garden has a big Garden Room. This we designed in conjunction with architect Andrew Wells. The concept was to make it predominantly glazed but use the local stone walling (also used in the greenhouse and cascade) to form the back and part of the side walls to allow the room to feel very much part of the garden. We wanted a wood-burning stove because the smell of a log fire is so evocative and almost the antithesis of hospital smells. It also encourages conviviality – important, as Becky had told us that patients would spend hours on their beds, glued to their tablets, with little interaction. They had their first quiz night in the garden room last week, which sparked ideas: they want more quizzes, a family night, a DVD night and a mini market at Christmas.

Each Horatio’s Garden has a different designer, rather like the Maggie’s Centres for cancer sufferers. All the gardens have a major horticultural element, so each has a head gardener. Imogen Jackson was appointed, and she now nurtures patients, a team of volunteers, and plants.

Horatio's Garden within the grounds of Robert Jones and Agnes Hunt Orthaepaedic Hospital, Oswestry Credit: Andrew Fox

The charity that Olivia and David set up has become a real force in the eight years since its work began. This is thanks to Olivia’s multifaceted talents and skill as a fundraiser. The Telegraph Christmas Appeal of 2015 was a big boost, and was pivotal in its growth to become a national charity.

Olivia works far harder now than when she was a time-pressed GP, but the many similarities of the two roles are helpful. As a GP she was a coordinator of the care and services required by her patients, and her clinical background means she understands the huge issues around working in a hospital. Lots of training is necessary for the staff and volunteers so that they comply with the necessary legislation.

All the spinal centres in the country have realised that Horatio’s Gardens are fulfilling a huge need and making a real difference. They are a neat solution and have so many beneficial effects. Now they all want one.

Two more gardens are under way, one designed by Tom Stuart-Smith, the other by Sarah Price. No doubt more will follow. Horatio is making a massive difference to many people’s lives. Little could he have known what an amazing legacy he would leave to patients, even though he was not able to become a doctor. Many people are hugely grateful. Thank you, Horatio.