The success of the Green House mode demonstrates the value of a central, shared, domestic-scale communal area composed of living area, an open kitchen and dining area, collectively called a ‘hearth’. Meals are prepared in the open kitchen by caregivers and shared at the common kitchen table. This shared area is typically connected to a protected outdoor space, where in the more successful settings the doors are left unlocked, and the outdoor space is used for activities and socialising (Cohen et al., 2016).
Restricted access to common areas or shared living areas can be isolating for residents and a balance must be struck between social engagement, communal activities, and infection control. This issue pre-dates COVID-19 with Stone arguing that “Maximising quality of life for the resident while minimising transmission of infections is a known challenge facing NH staff” (Stone et al., 2015). While more research is required in this area, it is useful to consider the advice set out by the AIA (2020) to change layouts in shared spaces to facilitate social distancing or provide outdoor seating and exterior social areas for occupants and visitors.