Building a home tailored for a child with complex medical needs, required innovative design and careful planning by Sarah and Steve Land and their architect, resulting in a space both functional and inviting

TEXT Jayne Dowle IMAGES Transform Architects

When Sarah and Steve Land decided the time was right to build their own house, designed with their severely disabled young daughter at its heart, their overriding aim was to meet all her complex medical needs, without ending up with a home that looked like a hospital.

Working with architect Martin Bell, whose West Yorkshire-based practice, Transform Architects, specialises in accessible home design, the Lands devised a new house that would give eight-year-old Heidi a comfortable, supportive and stimulating environment to grow up in. She has cerebral palsy and multiple medical conditions following a HIE (Hypoxic-Ischaemic Encephalopathy) event, meaning she went without oxygen shortly after birth.

The start of Heidi’s new home was her parents purchasing a 1970s bungalow, then demolishing most of it and starting again. Sarah and Steve had been looking at plots for their self-build project for months. After one purchase fell through, Sarah admits to becoming a Rightmove obsessive. As soon as they saw the property, which cost £720,000, they knew it felt right.

“The plot was perfect because it has level gardens which were really appealing for us to suit Heidi as she enjoys being outside,” explains Sarah, 45, who runs Peeps, a charity she set up in 2018 which supports parents of HIE children. Steve, 40, is an insurance broker and co-founder of Peeps, and their architect Martin is now a trustee of the charity.

Accessibility is all in a project like this, Martin explains. For Heidi’s new home, this involved designing wider doorways and corridors, no-step entries, wheelchair-accessible spaces and bringing in smart home technologies to open doors, for example.

“We have ensured there are no barriers or steps that would impede movement within the home,” Martin says. “Level access is crucial for wheelchair users or anyone with mobility issues. This means designing thresholds, entrances and pathways that are flush with the ground, removing potential obstacles.”

To promote well-being – and to help energy efficiency through solar gain – large windows, strategically-placed skylights, and an orientation that captures the surrounding natural views were crucial considerations. Steve says one hugely practical addition was “lots of plug sockets,” providing flexibility all over the house for Heidi’s equipment.

 “We were fortunate to be in a financial position to be able to do this project, so thought we would go for it,” Sarah says. “Heidi’s equipment takes up a lot of space, as she gets older she’s growing bigger and her needs are increasing, so this was a much-needed move.”

Heidi’s condition means she is non-mobile and non-verbal. Fully tube-fed, and with a tracheostomy (an opening in her windpipe to help air and oxygen reach her lungs), she also suffers from dystonia (abnormal muscle tone), epilepsy, hearing and vision impairments and global developmental delay.

The family’s former home, a semi-detached house 15 miles down the road from their new home, in Uppermill, near Oldham in Lancashire, had an open-plan kitchen/living room/diner.
The Lands had installed a through-floor lift from the ground floor to Heidi’s bedroom, where there were also ceiling track hoists from the bedroom to the bathroom. They stayed here during the build, from April 2021 to June 2022, selling it afterwards.

Now they live in a spacious 401.15 sqm, four-bedroomed property. The only complete part of the existing bungalow left is the garage, with its dog shower, retained as the family own a cockerpoo named Betty, and half-mezzanine floor for storage. Steve’s one regret is that during the build he didn’t have the mezzanine extended to full-floor, to provide further storage.

Martin’s plans were bold. They dispensed with the existing conservatory at the back of the house, adding a full-width extension in its place. This is designed with two apex roofs – one over the kitchen, one over the living room – with sliding doors opening off each space, and a French door in the central connecting area. Underfloor heating and a wood-burning stove keep this open-plan space cosy.

The front of the bungalow, between the garage and the front door, was reconfigured to create a spacious hall with a gentle entry slope and ample space for Heidi and her wheelchair. 

The exterior combines cedar cladding, echoed in natural internal touches such as the living television’s wall cabinet, with white render and anthracite windows and door frames for a highly contemporary look. Even though the existing bungalow was being extended, it wasn’t increasing in height or affecting any of the neighbouring houses, so the planning permission process did not hit snags.

Martin explains that a key priority was to ensure that Heidi – and her waking carer, who looks after her four nights a week – had her own space and privacy. There is a sofa bed in the sensory room should a sleep-in carer be needed in future.

He has zoned the house so that Heidi’s bedroom, fully wheelchair-accessible ensuite, sensory room – she’s a huge fan of BBC’s Strictly Come Dancing, so there’s a glitterball hanging from the ceiling where there’s also a hoist so she can explore and engage with the room safely – and a carer’s kitchenette where medication can be prepared and equipment cleaned, all sit together. As Heidi grows older, this area of the house will be established as her own, allowing as much feeling of independence as possible.

Two bedrooms, including Sarah and Steve’s with its own ensuite, sit across the hall. The family’s communal living space is towards the back of the house, directly onto the rear garden.

The communal living space comprises an open-plan kitchen, living room and dining area. There are also practical additions including a pantry and utility room off the kitchen, and a home office next to the garage.

The first-floor dormer bedroom was re-thought and made larger by incorporating loft storage space into the room’s floorplan. Storage has been incorporated within the new, extended ground floor. The first floor now feels spacious and light as a rooflight has been added on the landing.

To match what was left of the original bungalow, the new house has piled foundations and traditional cavity wall construction. It is highly insulated to keep energy usage as low as possible. Cavity walls have full 100 mm fill Rockwool batt insulation. Floors have Kingspan K103 to a thickness of 75 mm. The roof has 100 mm K107 Kingspan Kooltherm Rigid Insulation and 42.5 mm K118 Kingspan Insulated plasterboard with staggered joints, with blanket-like insulation batts fitted between rafters where necessary.

Sarah and Steve belong to several online forums of parents with disabled children in similar situations. That’s how they found Martin, as he came warmly recommended. The Lands say it’s important to take time to chat with other people who have undertaken similar work when planning such a project.

“Always go with your gut feel,” says Steve. “Everyone spoke so highly of him and his was the name that kept popping up. Our first conversation with Martin was such a positive one, we knew we wanted him to design the house. He understood what life might be like for us, asked about Heidi’s needs, and took time to discuss what was important to us as a family. We loved the design as soon as we saw it and knew it would work well for us.”

The couple also took online advice when deciding what they needed to make their new house as practical (there are hoists in Heidi’s bedroom and bathroom, where there is also a rise and fall bath and a changing table) as well as good-looking as possible. Working in collaboration with Martin, they looked at online projects and magazines too to see how other people had adapted homes, and soon got a feel for what they were looking for.

It took time to decide exactly what Heidi would need and balance the budget so every penny of the £550,000 build and fit-out budget was spent wisely. 

“It’s not necessarily that there’s a limited choice of accessible equipment for the home,” says Sarah. “A huge barrier for a lot of people is the cost. It’s a narrower market, anything with special needs or adaptable in front of it, there’s the question of it being affordable.” 

They took well-considered decisions, for instance not paying for a rise and fall sink – “you’re looking at £4,000, just for a sink”, Sarah points out – because Heidi is always in her wheelchair, at the same height.

Choosing a durable material for the floor, which will receive a lot of wheelchair traffic, was a key priority of the specification. “We have Amtico throughout, except in Heidi’s wet room where we have Altra flooring, and the first-floor bedroom is carpeted,” says Sarah. “Amtico is hardwearing and looks good, so it’s ideal. Everyone says it’s easy to look after. But it’s not so easy when you’re mopping the floors, I didn’t anticipate how you would have to keep on top of it in an open-plan house. Steve keeps saying we need a ride-on floor machine.”

It’s hard to guess how Heidi feels about her new home, say her parents, because she can’t tell them exactly what she’s thinking, but she settled in without any problems at all. 

One of her favourite things is to go outside – there are aluminium-framed French doors from her bedroom and sensory room, to match the aluminium-framed sliding doors into the garden from the living room and kitchen. The garden now includes a hot tub and barbeque hut, and has relaxing views over the nearby hills, so it’s both a sociable and relaxing space. 

She also loves her sensory room, where she can enjoy her favourite things, lights, music and Strictly Come Dancing, of course. “Since we moved in, her sleeping routine is much improved too, the air conditioning is much better than trying to cool her down with fans,” says Sarah. The ventilation and air conditioning in Heidi’s bedroom, part of the whole-house MVHR (mechanical ventilation with heat recovery) system, and in the sensory room help regulate her fluctuating body temperature when she’s asleep.

The benefits of transforming this bungalow for family life with a disabled child are immeasurable. Sarah and Steve can now safely and easily do things at home with Heidi, with everything at hand, customised specialist equipment and plenty of space. 

“At the other house daily life was becoming a struggle,” says Sarah. “And as Heidi has got bigger, it was becoming difficult for us to visit other people if their houses weren’t accessible. Heidi’s sociable, and now our friends and family can come to us, we’ve had some lovely times together – and that’s just fantastic.”

For Steve, the new house has made a huge difference to daily routines. “Heidi has always been our priority,” he says. “So having a home that meets all of her needs, and is future-proofed for when she is bigger, means it’s easier for us to manage day to day, and we can focus more on enjoying life.”