Helen House case study

Helen & Douglas House, Oxford (Young People's Respite Centre / Hospice)


Helen House was the world's first children's hospice, opening in November 1982. It was set up to help families cope by providing occasional respite care modelled on that provided in the family home - personalised and tailored to individual needs. The building houses eight children's bedrooms with support facilities and these all look out onto the gardens.

Project description

Helen House garden represents an oasis of peace and quiet in the heart of Oxford, a densely populated city. Though a relatively small area, the numerous trees help to divide the garden into a variety of spaces so that it offers both communal areas and also privacy. Secluded corners include a slightly separate ‘Quiet Garden’ where families can find time to reflect or be still without being disturbed. There is also plenty of space for running around and larger family groups can spread out on the lawn together.

The centre-piece of the garden is a large tree-house constructed at ground level round a mature lime tree, with a ramped access suitable for even larger motorised wheelchairs. Small windows look out onto the garden, adorned with tactile sensory ornaments hanging down which catch the light as they turn. The structure is just exciting to be inside and no-one would consider it to have been just designed for wheelchair-users. Events are held in the tree-house including Easter Egg hunts, summer picnics, halloween and Santa’s Grotto. The flexible design can make it an airy shady spot in summer or a cosy den in winter.

‘The children love the tree-house in the summer, but at Christmas we transform it into a winter place. The Snow Queen and a polar bear have visited and Santa sits and gives presents to the children. There was one young girl who was very sick, but the staff were so determined that she should get her wish to visit Santa that two of us dressed up as reindeer and pulled her bed outside to see him’ (Care Team member).

There is also play equipment for all abilities, lawn and terrace areas, novel water features, and meandering paths. The garden is well screened round the perimeter by a dense belt of trees.

Key achievement

The garden is genuinely an integral part of the healing environment to the degree that it is used regularly all year round, particularly the Tree-house which forms the focal point of the garden. All the rooms are at ground level and look out onto the garden, so access is very easy. All-weather path surfaces make the garden accessible at all times of year.

What are the health benefits?

Helen House Garden offers health benefits for patients, staff and visitors. Many of the children at Helen House are very ill indeed so even those who are able to go outdoors will often not be able to be physically active or have enough mobility to take full advantage of the outdoors. However all of the children, however ill, enjoy the feeling of sunlight on their face and the sound of the wind rustling through the grasses.

For those involved in their care, whether staff or family members, being able to escape outside for a moment and watch the squirrels and birds feeding, or just read a book in the sunshine, helps defuse the stress and tension, making the task of working in (or visiting) a little bit easier.

Staff perspectives

‘At Helen & Douglas House we care for the whole person and their family. We have a specialist medical team, nursing and care teams offering one-to-one care, the Family Support & Bereavement team, a teacher, as well as things like aromatherapy, spa, music and art therapies. The aim is to meet the medical, social and emotional needs of the young people and their families when they are with us. We see the whole environment as an extension of this and the garden is a very important part of this holistic approach.

At Helen House the children’s bedrooms all look out onto the garden and this really adds to the sense of peace and beauty surrounding us. The sensory garden means that even the most profoundly disabled children can enjoy the textures, smell and feel of plants and other aspects of the garden. The children are offered space and time to enjoy areas such as the wheelchair accessible tree house, swing and roundabout. Families and visitors can also relax there and our staff and volunteers also have a space to take a well earned break.’

Clare Edwards, Director of Clinical Services, Helen & Douglas House.

‘Being in the middle of Oxford it has made such a difference having a special quite area where I can take families to talk and where no-one can see if they get distressed. Parents can also come here on their own if they need private time’.

Bereavement counsellor

Lessons learnt

  • An all-season tree-house extends use of the garden year round, but it was not without problems: the ramp led straight down to some French windows and became slippery when wet, so special matting was installed; also, shutters facing onto nearby bedrooms were fixed shut for privacy;
  • The raised planting beds need to be at the right height for children – they had to be lowered and made wheelchair friendly;
  • The perspex water feature is not easy to maintain and a specially-designed filter was added, to stop children placing small toys down the opening.


Website: http://www.helenanddouglas.org.uk/

Picture credits: Helen House