The asylum is situated in the parish of Coulsdon, on the Surrey hills, about five miles from Croydon, and two and a half from Caterham Junction station on the L.B. and S.C. Railway, close to the Brighton Road, which forms the east and south-east boundary of the estate. A short distance off, in a cutting and parallel to the road, is the railway. The estate consists of 151 acres (of which two have been recently purchased for the purpose of a cemetery). The geological formation is chalk, covered with a varying depth of earth, but for the most part shallow. In one corner of the estate is a valuable bed of flint, gravel and sand, by using which in the making of roads and pathways, also for building purposes, great saving has been effected.
The site of the main building is an elevated plateau, 450 feet above the sea level, and 180 feet above the Brighton Road, commanding extensive and beautiful views of the surrounding country. The levels of the plateau differ as much as 26 feet; nevertheless, the architect has so ably contrived, by sloping the covered ways and passages connecting the various blocks, that any portion of the building can be reached without going up or down steps.
Before building operations commenced, a well, 97 feet deep from the level of the road, and eight feet in diameter, was sunk in the chalk. From this well is procured an unfailing supply of pure water; this has been fully proved during the present protracted drought, when most of the other wells in the neighbourhood have failed.
The asylum is designed on the block system, with connecting corridors. The whole of the administrative offices are in the centre. The main front, having a south-eastern aspect, consists on the right half of the Medical Superintendent’s house, with office connected; on the left the committee-rooms, Clerks’ and Medical Officers’ offices; Medical Officers’ quarters on the first floor and the Sub Officers’ on the second floor. Then from the front, backwards, are the chapel, with retiring rooms, Chaplain’s room and library, surgery, recreation hall, sculleries, vegetable-room, officer’s mess room, kitchen, dairy and meat store, steward’s store, bake house, laundry and wash house, engine and boiler house, water tower, coal stores, workshops and mortuary.
The chapel, a building in the early English style, is of simple and beautiful design; it is capable of seating 800 persons, and contains a fine organ. The recreation hall is lofty and well proportioned. At one end is a gallery, at the other is a large stage most completely fitted up, and having beneath it extensive property and dressing rooms.
The sculleries and vegetable room are connected with the kitchen, so that all who are employed in them are under the immediate supervision of the cook. The kitchen is large and well arranged, there being ample means provided for cooking by steam, gas or coal. The meat store is large, well designed, and ventilated.
The steward’s stores are very spacious; there is a large basement from which a tunnel leads into the yard, whereby all heavy stores are brought into the centre of the building without passing through the covered ways and corridors used by the patients. The laundry department is unusually spacious, and fitted with the most approved modern appliances, both for hand and machine washing. The drying closets are far beyond the usual allowance. Soft water from a tank in which all the rain-water from the roofs is collected is available for washing. All these offices have been designed with a view to the future enlargement of the asylum.
The water tower is 107 feet high, and the cistern is capable of holding 34,000 gallons of water. From the hydrants connected with the fire main, jets can be thrown over the highest parts of the building.
The wards radiate from and are connected with each other by semicircular corridors. They present great variety in form and size; probably no asylum was ever original built with wards of so many sizes and shapes.
The infirmary ward (A) is specially adapted for the reception and treatment of the sick and infirm; this is a building of two stories,
and both floors have day and night accommodation, thus obviating the necessity of continually carrying helpless patients up and down stairs. B and C
wards for the epileptic and suicidal cases are almost identical in construction: they also are of two stories, and have day and night accommodation
of both floors. Connected with their dormitories are single rooms, planned with a view to continual night supervision, having open panels to the doors
and a gas lamp throwing light into the room. D ward is for the treatment of general acute cases. In this ward the proportion of single rooms
is high, and two of these are padded. The dormitories also contain fewer patients. E, F, G and H wards are for the chronic working cases,
where a large proportion of attendants and nurses are unnecessary. Each ward is most complete in itself, containing day rooms and dormitories,
closets, and in A, B, C and D wards, bath-rooms on each floor; for the other wards there are in either division two large general bathrooms,
containing nine baths, with dressing-rooms attached.
The wards and passages are brilliantly lighted by gas. The warming and ventilation throughout the building have been carefully considered; as a general rule the whole of the day rooms, dormitories, single rooms and corridors occupied by the patients are warmed by hot water coils, supplemented by open fire-places in the wards. In every part of the building means have been provided for the introduction of fresh air and the extraction of the foul, so as to secure during the day and night a constant change of atmosphere.
The water-closets are built in towers entirely cut off from the wards by interrupting passages, freely ventilated. The water is supplied by an efficient seat-lever action, fitted with ‘anti-percussion’ valves; the soil pipes are carried down the outside of the towers, and open at the top on a level with the roofs. At convenient points are inspection plates, and all are efficiently trapped; the drains are all carried outside the building.
Situated a short distance from the main building are the gardener’s and farm bailiff’s houses, in each of which there is accommodation for 12 male patients. There is a cottage hospital for infectious diseases, with accommodation for eight patients of either sex. At present, not being required for its own special purpose, it is occupied by twelve quiet women, under the charge of a married nurse.
In each of the wards and in all the administrative buildings, is a hydrant enclosed in a cupboard having glass panels, and in the same
cupboard are a hand pump, spanners, nozzle, and sufficient canvas hose to reach any part of the ward or building. At convenient fixed points about
the corridors are extincteurs, hand-pumps and buckets. There is on the staff a trained fireman, late a member of the London Fire Brigade, whose sole
duty is to keep all the appliances in efficient working order, to train nurses, attendants, and other members of the staff in their use, and to drill
the fire brigade, which consists of two divisions, for the saving of life and the extinction of fire respectively. For the former purpose there are three
fire escapes, jumping sheets, life lines, etc., and I may here point out that all the wards have two staircases, one at either extremity, except A,
E and G, and these are buildings of only two stories and easily reached by the escapes. Considerable efficiency has been attained by the staff in the
use of all the appliances, and competition has been encouraged by the award of small prizes to the most proficient.
The furniture in the wards is simple in design, but of good and substantial character. It is made of birch, the bedsteads also
being of this wood, except in the infirmaries, where there are a certain number of iron "excelsior spring" bedsteads. In most of the single rooms
the bottoms of the beds consist of cross battens, secured with screws, thus necessitating straw paillasses beneath the hair mattress. In all the
other dormitories the bottoms are constructed of loose longitudinal lathes which form a spring upon which the horsehair mattress is laid; these beds
are very comfortable and highly approved of by the patients. In the observation single rooms in B and C wards are low-frame bedsteads of novel
construction; they consist of solid birch frames, which, by a simple contrivance, lock to the floor, the patient is unable to pull this bedstead
about, and should a fall take place the padded edge prevents injury; the height from the floor is only eight inches. Over each mantelpiece in the
day rooms is a mirror. Linoleum of bright and varied patterns is arranged in strips upon the floors of day rooms and dormitories, the edges protected
by a narrow wood beading. In the day rooms the intervening spaces are polished. Ornaments, such as engravings, oleographs, plaster figures, china ware,
aquaria, fern cases, and bird cages, are being gradually introduced. The patients are also making curtains, antimacassars, etc. which add a great air
of comfort and homeliness. The greenhouses are nearly completed, and the plants grown in them will be an attractive addition to the wards.
A great deal is required in the way of decorative painting, etc.
The clothing of the patients is varied in the material and colour, as little uniformity as possible being observed. Each man and woman who is able to appreciate the privilege has a best dress of suit for Sundays, entertainments, or when walking beyond the boundaries; each man has slippers provided to wear indoors. The diet is good and ample, the most noticeable point being that beer is omitted from the ordinary dietary; but complaints on this score are seldom if ever made. The patients working on the farm and garden have oatmeal drink or lime-juice with the water sent around to them morning and afternoon, in summer. The sick diet is very generous, and alcoholic stimulants are ordered at the discretion of the Medical Superintendent.
In the wards are provided chess, draughts, dominoes, cards, bagatelle, and for the male division a billiard table. In two of the female wards are pianos. A library is being formed, and there is an ample supply of daily and weekly papers and periodicals. The associated amusements are in the winter season held weekly, and consist of dances, concerts, theatricals, dissolving views, conjuring, and nigger minstrel entertainments. In summer, cricket matches and open air amusements. The band plays twice weekly in the recreation field. I here take the opportunity of thanking those ladies in the neighbourhood who so kindly sent each patient, attendant, and nurse, an appropriate card and letter at Christmas, also those ladies and gentlemen who have rendered assistance at concerts and theatrical entertainments.
The airing-courts have been tastefully laid out and planted under the direction of Mr. Lloyd, head gardener of Brookwood Asylum. They contain a large number of fine trees, which, with great forethought, were spared when the asylum was built. The walls are sunk, the view being uninterrupted, and the idea of confinement being thereby considerably lessened.
EMPLOYMENT OF PATIENTS
Great attention has been paid to the employment of patients. The principle work of for the males is on the farm and garden (the usual number so employed being nearly two hundred), shoemaking, tailoring, hair-picking, coal carrying, ward and domestic work. For the females, needlework, washing, cleaning vegetables, and assisting in the kitchen, ward work, and household duties.
Prayers are held every weekday in the chapel at 8 a.m., and services on Sunday at 10.30 a.m. and 6 p.m. There is an excellent organ, and a choir is carefully trained by the Chaplain. The Roman Catholic patients are visited weekly by a priest. Arrangements are being made for opening schools immediately in both divisions.
From the opening of the asylum until very recently interments have taken place at Coulsdon Churchyard. Two acres of land, conveniently situated, have been purchased for the purpose of a cemetery, and have been consecrated by the Bishop of Rochester. This will be ample accommodation for many years to come. It is to be surrounded by a wall, and a small chapel is being erected.
The estate is being cultivated for the most part by patients’ labour. The kitchen garden, 17 acres in extent, is being laid out. Eight acres of Italian rye-grass are under sewage irrigation by a very simple but effectual system, advantage being taken of the natural fall of the ground.
The staff consist of a medical superintendent, senior and junior assistant medical officers – the former in charge of the female, the latter of the male division; they are assisted in their duties by a dispenser. A chief nurse, assisted by a deputy, in the female, a head attendant, also assisted by a deputy, in the male division. There are forty-seven day and seven night nurses in the female, and thirty-seven day and six night attendants and one nurse in the male wards.
The administrative staff consists of a clerk, steward and storekeeper, housekeeper, assistant clerk, and assistant steward; there is a clerk of works, who has charge of the building structurally, and an engineer, who is responsible for the engines, boilers, hot and cold water supply, gas fittings, baths, water-closets, sinks, etc.
The asylum buildings are constructed to accommodate 644 females and 480 male patients. On the 25th March there were only vacancies for 140 more patients.
