Step Change Design Ltd.

Step Change Design Ltd. Step Change Design Ltd. aims to help the Care Sector enable their Residents to actively and meaningfully use their gardens.

Step Change Design is a design and consultancy practice that aims to promote a new approach to to enable care settings to increase engagement levels for residents, particularly those living with a dementia, with their outside spaces. Our aim is to share the key findings from our large scale research project, and to promote a new approach to how design support is delivered with care setting clients

we call ‘Relationship-Centred Design’. We are two Garden Designers, Debbie Carroll and Mark Rendell, who set out to answer a deceptively simple question, “Why aren’t care home gardens more actively used?” As designers, we were concerned that a lot of money was being spent by often cash-strapped care organisations on a new garden, in the belief that it would encourage more use of the outdoors, when this didn’t seem to be happening in practice. Our self-funded research projec threw up some unexpected and often subtle practices at work across the care sector. We discovered the answers to our original question and this was that active engagement with the outside spaces around care settings is related to care cultural practices inside the care setting. The higher performing care settings (in terms of person-centred and relationship-centred care practices) were engaging residents with their gardens more actively, regardless of how pretty these spaces were or whether or not they had been designed. We have been writing articles and blogs following publication of our 'Care Culture Map & Handbook' tool. We have presented at Conferences organised by NAPA, Journal for Dementia Care (UK Dementia Congress), Eden Alternatives, Landscape Show and other events explaining our findings, our diagnostic tool, the Map, and our key messages that it is care culture that ultimately determines how actively used the outside space will be. We are keen to share these insights and findings with as wide an audience as possible across the Care sector and also with designers and outdoor specialists, so that investment in the outside spaces around care settings (and what takes place there) will be cost-effective and result in gardens that are well-used and well-loved by their residents. In the care sector, we are now fairly well known as culture change advocates as much as designers while in the Design sector we are promoting a new way to deliver our design support to ensure it is appropriate and effective for the long term. You can read a selection of our articles to date on our website. We are keen to join other agencies and networks both in the UK and beyond in important debates around care culture and and its influence on creating and using the outside spaces around care settings.

As its I thought I'd share a few statistics from our study and that appear on our 'Why don't we go into the garden?' b...
22/05/2026

As its I thought I'd share a few statistics from our study and that appear on our 'Why don't we go into the garden?' beautiful A3 infographic poster to help your care teams get the most from the garden and support your residents to step outside more.

1/ Take a seat–where there is seating in care gardens residents will stay 20% longer. Have you got plenty? Keep it flexible to sit alone,in a group,in sun or shade. Make them sturdy to aid getting up. Place near doors to aid transition from in to out.

2/ Stepping into the garden couldn’t be simpler for care settings – if you go with a residents they will stay 31% longer. So what’s stopping you – its good for all of us to get outside.

3/3 Food & drink tastes better outside. Taking a meal or drink outside saw residents stay 80% longer. You’re already serving them so why not simply take it outside & change of venue. For some it may improve appetite too.

More thought provoking statistics on our infographic poster, so why not get a copy and get the conversation started and embed the garden use so it continues long after the summer fades.

This colourful poster shares the key statistics from our research project into what makes care home gardens more actively used. Ideal for care home staff.

It’s that time of year again – RHS - Royal Horticultural Society Chelsea is on the telly, all those amazing gardens and ...
18/05/2026

It’s that time of year again – RHS - Royal Horticultural Society Chelsea is on the telly, all those amazing gardens and many with health and wellbeing stories to share. I really welcome the RHS blueprint for creating Well-being gardens, including for those within organisational settings.

https://www.rhs.org.uk/advice/health-and-wellbeing/blueprint/for-organisations-and-communities

I thought it may be helpful to flag a couple of useful resources within this guide for care homes:
· Benefits of gardens and gardening on health & wellbeing (Pg23)
· Range of simple activities to do in the garden (Pg30)

Our own research identified the role of the care organisation’s culture, its practices, policies and attitudes, on how actively used a garden will be - long after the creation of a new space. The key driver to success is delivering truly person-centred care practices – which is aligned with CQC requirements.

Why not take a look at our video for an overview of our findings. Watch to the end to see how our original research question became the solution to ensure residents can enjoy the garden as they wish and gain the health benefits to be found there.

https://stepchange-design.co.uk/our-research/



(Re the Photo: I've been fortunate to have helped plant for a number of other Designer's large gardens at RHS Chelsea. This was one of me having helped plant a Trade Stand for Sarah Eberle & Nadine Charlton in 2019)

16/05/2026

Todays the day!

All my Hampshire followers, we'll be at this friendly dementia information day in Romsey tomorrow. Come along and share ...
16/05/2026

All my Hampshire followers, we'll be at this friendly dementia information day in Romsey tomorrow. Come along and share to anyone who may find it helpful.

Romdag Dementia Friendly Hampshire Dementia Community Dementia Adventure

Shared with Dropbox

Off on a magical mystery tour, we'll not really a mystery but going via King's Cross so has a magic touch ( not platfor...
11/05/2026

Off on a magical mystery tour, we'll not really a mystery but going via King's Cross so has a magic touch ( not platform 9 3/4).

York 1st - York University project My Home My garden as adviser. Get to hear latest insights.
Then detour to see family in Newcastle.
On route home I'm popping in to see MHA Willersley House, Hull, and the garden we created last year. Apparently the woodland walk has been used every day by residents rambling group.

Garden design is about more than aesthetics—it’s a powerful tool for enhancing wellbeing. Our research shows that when g...
05/05/2026

Garden design is about more than aesthetics—it’s a powerful tool for enhancing wellbeing. Our research shows that when gardens are designed with a deep understanding of the people who use them, they can transform daily life, especially in care settings.

A well-designed garden alongside person-centred care practices encourages residents to engage with nature, supports their independence, and reflects their personal needs and wishes.

The real magic happens when the culture of care organisations supports and values outdoor experiences in the day to day lives of their residents. In such environments, gardens become vibrant, lived-in spaces that foster connection, relaxation, and joy. It’s not just about the plants or the layout—it’s about creating places where people feel empowered and supported to enjoy the outdoors, every day, doing what they love.

What brings joy to your residents lives outside?

I’ve an early morning coming up as I’ll be a part of a panel style webinar for Dementia Training Australia as part of th...
28/04/2026

I’ve an early morning coming up as I’ll be a part of a panel style webinar for Dementia Training Australia as part of their webinar series for the Australian Government’s, Department for Health, Disability and Aging, webinar series.

This webinar will be on ’Principle 3 – Access the outdoors’, from their ‘National Aged Care Design Principles and Guidelines’. Alongside Landscape Architect Nathan Clausen and Architect Nick Seemann we will explore a range of areas to support creating meaningful and engaged with outside spaces in care environments.

Why not join us, 30th April 2026 2:00pm to 3:00pm AEST, which is veryearly here in the UK, or you will be able to watch back at your leisure.
https://www.health.gov.au/resources/webinars/webinar-5-principle-3-access-the-outdoors?language=en

LCGD Melbourne

This webinar is for people working in aged care and design. Learn about the importance of spending time outdoors for older people living in aged care.

Love the Montessori Care approach.
26/04/2026

Love the Montessori Care approach.

There is something deeply human about feeling the sun warm your face, a gentle breeze on your skin, or listening to rain tapping softly on a rooftop. The rustle of leaves, the changing colors of the sky—nature offers 365 days of rich sensory experiences that speak directly to our wellbeing.

For people living with dementia in care settings, these moments are not “extras.” They are essential.

Research shows that after just 10 minutes in nature, people experience a noticeable sense of wellbeing. Imagine what regular access could mean—for both residents and the staff who care for them.

Yet too often, the outdoors becomes distant or inaccessible.

This is why the work of Debbie Carroll and Mark Rendall is so important. Their inspiring and practical research project has led to the development of a care culture map and a booklet full of realistic, doable ways to bring nature into everyday life in care homes.

Their message is simple and powerful: Why don’t we go into the garden?

It’s not about grand landscapes or perfect weather. It’s about small, meaningful moments—stepping outside, opening a window, feeling the air, noticing the sky.

We can do better. And it starts with recognizing that nature is not a luxury—it is care.

I highly recommend exploring their work 🌿Stepchange Design

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