Objectives: To report on the views of people with dementia who live in care homes and their family carers on aspects of design that are important to them, and discuss these in relation to developing physical care environments that respond to the wishes of people with dementia and their family carers. Method: Six focus groups were held: two in Northern Ireland and four in Scotland. A total of 40 people participated in the focus groups. Twenty nine people were with dementia (24 female and five male), and 11 were family carers (10 female and one male). Results: Carers discussed the features of a building they took into account when selecting a care home, and discussed this in relation to 'bricks and mortar versus people'. Key themes reported by people with dementia and their family carers included how the space in the environment is used, for example, what happens in the building and the presence or absence of certain design features. Outside space and wayfinding aids were identified as positive features of the home, along with a general lack of concern about ensuite provision. Conclusion:The results demonstrate the complexity of building design as it must provide living space acceptable to people with dementia living there and family members who visit, as well as provide a workable environment for staff. The findings highlight areas that should be considered by care home teams involved in the build of a new home or the redevelopment of an existing care home.

With more people with dementia living in care homes in the UK than ever before, there is growing recognition that the design of such internal and external spaces should meet dementia friendly principles. This paper reports on one part of a study to evaluate the reliability and validity of two tools: The Design Audit Tool and the Environmental Audit Tool developed to audit how dementia-friendly internal and external environments (specifically care homes) are for people with dementia, and presents a qualitative analysis of the reports presented to care homes following each audit. Thirty care homes took part in the study to evaluate the design audit tools and, following good practice, received a home report detailing up to five design strengths and five limitations following the audit. Analysis of the home reports identifies variation and variability in meeting dementia-friendly principles as specified by both tools. Areas of variability included wayfinding, the use of colour and contrast, access to outside spaces, individualization of personal and communal spaces, lighting and opportunities to engage with the environment. This paper provides valuable insights into variability in care home design and identifies common areas of weakness and strength in care homes of different type, ownership and localities.