WHY DOES IT MATTER TO BUILD ACCESSIBLE HOMES?

Going to the toilet- it’s something most of us just take for granted at home. But imagine if you can’t just ‘go’, for whatever reason (you’ve had an accident, you’ve developed a health issue). Then what?

 

Chances are, you may have to wait weeks- or months- for alterations to your home, to install a WC at entry level, to adapt your bathroom so you can use it. Inbetween times, the extreme is that you could be faced with the indignity of having to use a commode, possibly even sat in your lounge.

 

It’s a situation that is likely to affect increasing numbers of us. Our population is ageing. We have a growing number of disabled people- currently almost 14m people, equivalent to 20% of the population.

 

Bear in mind, 80% of those registered disabled were not born with their disability, it happened- they developed an illness, had a life changing accident. It can happen to any of us. For those people who need their homes adapted, the bathroom is the room most frequently in need of adaptation, and the toilet the fixture therein that is most often changed in some way.

 

It sounds stark, but that’s the reality. It’s just one reason why it is so important we get behind the latest drive to make a realistic proportion of new build homes accessible and adaptable- in effect, what is already laid down in Building Regulations as the standard- Approved Document M 4(2).

 

It is an aim of Habinteg Housing Association, which has just published a report into the need for accessible homes. It is lobbying the Government to make accessible, adaptable housing to M4(2) a mandatory baseline in Local Plans.

 

 

Key elements of building accessible, adaptable homes are doorways wide enough to accommodate wheelchairs, level access, an entrance level WC, and a structure strong enough to bear the addition of aids such as grab rails, particularly when under load. To design a layout where the main bedroom is on the same floor- and ideally with doorways in line with- the bathroom (to facilitate subsequent addition of a ceiling track hoist).

 

It isn’t actually that hard to do. Nor is it expensive. But it will save the Government- and therefore us in taxes etc- vast sums of money in ensuring homes are fit for life, for purpose. Build accessible homes, and you reduce the need to retrospectively adapt them, with all its associated cost and disruption. You reduce the need to rehouse people into suitable homes. You reduce their need for care support. You reduce the need for NHS intervention.

 

We’ve managed to start addressing the need for affordable homes.  Let’s commit to achieving the same with accessible homes, to build homes for life.

Just for One Day?

With summer approaching, we all start planning trips, days out. But for the millions of families with a disabled member, those plans are too often curtailed by the fact they can’t find suitable toilets when they get there. They don’t just need a WC, they need help to be lifted from a wheelchair, or they need changing, or they need space to accommodate their carer(s) too.

 

So you find a situation where those families are thrilled that a venue has hired an assisted, accessible facility for a day. They invite friends to go along with them, excited that, for one day in the whole year, they can go to that place….

 

I fully acknowledge that mobile toilets have a value, and are a huge benefit. Not every potential venue is permanent- it may be a festival that runs for a few days; it may be small (eg a few hundred visitors/month), or a charity …

 

 

But people who need those facilities don’t need them just for one day.

 

They need them every day.

 

If you are a permanent venue, attracting thousands of people a day/week/month, and acknowledge that, to open our doors to everyone, you need to hire a mobile facility, why not put in a permanent facility?

 

Which is worse? To not have any such toilets at all, or to say to someone: ‘we recognise we need to do something extra to accommodate you, we’ll do that, but you can only come on one specific day’?

 

What impact would it have on your other guests’ enjoyment if you upgrade an existing wheelchair accessible toilet by losing a female cubicle, or a single urinal, to gain enough space to add a changing bench? Add a hoist whilst you’re about it- that doesn’t even take up any space! They won’t even notice, but it will make a world of difference to your guests who need those facilities- and your bottom line! They would be able to come whenever they like, as often as they like, not…

 

….just for one day.

 

Housing for All

There has been much talk in the media of late about the growing need for affordable housing.

 

What about the growing need for accessible housing?

 

New research has highlighted that there is a dire lack of suitable homes, whether in the private sector or social housing, to accommodate people with a disability.

 

Estimates put the current UK accessible housing stock at 5% of all homes. Disabled people represent at least 20% of the UK population: that’s a huge potential gap to be addressed! And with our ageing and increasingly obese (with all its associated implications) population, the need is only going to increase.

 

The research quotes examples where there has been a significant investment in time and money giving people rehabilitation and support to enable them to get out of hospital and into society, yet lack of suitable homes for them to move into means that effort is wasted.

 

There have been four Select Committee reports calling for national targets for accessible homes. There is a duty under the Neighbourhood Planning Act 2017 to consider the housing needs of disabled people.  But few local authorities actually implement anything.

 

If targets are set, they can be achieved. Greater London, for example, insists that 10% of newbuilds are wheelchair accessible; as a result the area is proven to have lower average waiting times for accessible homes.

 

It isn’t hard to build a lifetime/ accessible home: level access, wider doorways, a ground floor WC, and potential to add a hoist to aid transfer from, particularly, bedroom to bathroom, are key features.

 

So come on developers: lead the way whatever sector you operate in, just slightly adjust your designs and build processes, and enable millions of people to get on with living life.

And come on Government: legislate for national targets, make accessible housing a legal requirement. It will pay off: it will help reduce the pressures on other public services- particularly NHS and social care- by enabling people to be in their own homes, and independent.

DON’T MISS OUT…

A new report into disability(*) maintains that businesses could be missing out on a share of £420million in revenue a week, by failing to meet the demands of disabled people!

 

The same report also says a third of disabled people experience difficulties as a result of their impairment accessing public, commercial and leisure services; 17% of those say that inappropriate bathroom/toilet facilities are a barrier. That equates to at least 3/4million people being prevented from enjoying time out by lack of suitable toilets.

 

The report expands that location, layout and size are the biggest problems for disabled people and bathroom facilities. It’s why there is such a need for ‘bigger and better’ toilets- aka Changing Places. Under the new (2018) British Standard regarding inclusive buildings (BS8300:2018), a Changing Places should be at least 12m², include a ceiling track hoist, privacy screen, adult sized changing bench, and, ideally a wash & dry (shower) toilet in place of a conventional WC.

As I have said before, the Regulatory wheelchair-accessible toilet fails most disabled people. For a start, there are 13million people registered disabled in the UK, of whom “only’ 10% use a wheelchair. It is a Regulatory requirement to address their toilet needs, yet there is not a huge difference between them and the number of people who need the space and extra kit of a Changing Places.

 

We would maintain the figure is actually significantly higher than the report suggests. For example, 6.5million people have continence issues; 9million people suffer from arthritis; 0.5million people have acquired brain injuries; 0.25million people have a disease that affects their muscular control (MS, MD, MND); 1.5million people have a learning disability. All of these issues can impact on a person’s ability to go to the toilet on their own.

 

So why aren’t Changing Places a Regulatory requirement? Under current Regulations, and even under the new British Standard, the phraseology is only that such facilities ‘should be provided’. So if this lack of appropriate toilets has affected you, please ‘take five’ to do something about it: lobby your local MP to get the law changed.

 

Where a toilet is provided, it must address the needs of most, not the needs of the few, and be big enough, with the kit for as many people as possible to use it. That should be the minimum requirement.

ENDS

(*) Papworth Trust Disability in the UK

TAKE A STAND!

It is widely accepted nowadays that many people struggle- be it a little or a lot- to get up from their chair.  But few of us think beyond that scenario. Yet what about getting on and off the toilet?

 

THAT is actually a bigger problem, whether at home or out and about…

 

Reduced sit to stand function is such a common issue that there are now retailers within most large towns selling just riser recliner chairs. But, as outlined above, it is rare for that action to be associated with anything other than getting out of a chair. Yet almost as often,  we get on and off the toilet- on average eight times a day! And whether at home or out and about, often a grab rail just isn’t enough support or help.

 

Solutions do exist.

 

The obvious is to raise the height of the toilet so less knee bend, and lower limb strength, is required. Floor-mounted toilets can be made higher by the addition of plinths; a wall-hung variant can be moved up the wall. However, whoever is executing the work needs to ensure there is sufficient, or increased, pipework to accommodate the adjustment.

 

A toilet lifter helps people who do not have the muscle strength to push themselves up. It fits over the WC, and, at the push of a button, lowers and raises the user over the bowl, ensuring their feet remain on the floor.

Most deliver a tilting function as they rise, ‘tipping’ the user from sitting to standing, without the user having to rely on their own muscle strength. Some people find the tilting sensation unsettling, they don’t feel stable, and safe. The Aerolet, available from Closomat, is, to our knowledge, the only brand that also has a vertical lift option: this lifts the user without tilting the seat, eliminating that feeling of insecurity. (The Aerolet range can also be preset to individual user needs in terms of minimum and maximum lift height, thus accommodating the smallest to the tallest individual!)

 

The ultimate solution is an automatic height adjustable toilet, such as the Lima Lifter- believed to be unique in the market. At the push of a button, the toilet can be lowered and raised to the most comfortable height for the person using it- both for them to get on and off, and whilst sat. And it delivers the optimum in cleanliness- it has integrated douching and drying so there’s no need to manually clean with toilet paper. And the core height range can be preset at initial installation to accommodate the shortest and tallest user, within the tolerances of 455mm up to 755mm.

 

Artist Stella Maris, who has muscular dystrophy, sums it up: I cannot stress what a difference it has made. I am able to go to the toilet without assistance! It is fantastic for anyone with no sit to stand function. The rising function is crucial for me to do anything without help.”

Stella maintains the rising function is so critical to her daily life, she cannot even spend any great amount of time away from home in case she needs the toilet. One assumes everyone who uses a riser recliner chair at home has the same issue.

 

Is that your experience?

ACCESS THE VISIBLE AND INVISIBLE MARKETS

We’ve all been ‘caught short’- away from home and for whatever reason needed the toilet urgently. For most of us, it’s meant a dash to the nearest facility.

 

But what if you can’t dash? What if you have a disability- visible or invisible?

 

British Standards in best practice, particularly with regard to access & inclusion (i.e. BS8300:2018) have been updated, and now recognise that many disabilities are not visible, and that many people need urgent access to toilet facilities. For example, 6.5m people have continence issues- be it bladder or bowel- or both!

 

The Standard maintains that disabled people. It says they should be able to find and use suitable toilet accommodation no less easily than an able person. There is much emphasis in daily life on disabled equating to wheelchair. There are over 13million people registered disabled in the UK; there are 1.5million wheelchair users.

 

So the majority of disabled people don’t use a wheelchair. There are 6.5million carers in the UK. Thereoretically therefore, most disabled people, if and when they are away from home, have someone with them to help them.

Does that help extend to the toilet? Probably, even if it’s just to help open the door. It is another reason why there is such a need for a review of the legal requirements in the provision of accessible toilets.

 

Currently, if there is restricted space for any toilet, then the least that should be provided is a unisex wheelchair-accessible facility. In theory, it can be used by everyone. But for anyone who needs help, the venue’s door is still shut to them. There isn’t the space for a carer. There isn’t the privacy of even a screen.

 

We will never please all of the people, all of the time. But a slight change to the legal requirements would make society a lot more accessible to a significant proportion of the population.

WEIGHT AND TOILETING

There is a frightening connection between your body weight and your ability to go to the toilet.

 

It can mean that you can’t go to the loo without help. You need someone to wipe your bum.

 

The issue is affecting more and more of us- now 25% of the population is obese. New analysis says that obesity has tripled in the last 30 years. The research also maintains that, on figures relating to obesity, potentially there are over 12million people at risk of Type 2 diabetes.

 

Diabetes UK further says the number of limb amputations arising from the disease is at an all time high- more than 20 /day! The illness is the leading cause of amputation in Britain.

 

You may already be experiencing the impact that your weight has on your ability to go to the toilet. Think of the impact the loss of a limb has on that too.

 

For that most intimate of activities, you need help. You can’t easily get on or off the toilet. You can’t easily bend, twist, to wipe yourself clean. You risk falling off the WC if you try. You may be finding the seat brackets break more easily. You may not be able to sit properly over the pan. You may not be able to reach your intimate parts.

 

Going to the toilet is something we do on average eight times a day, so it impacts on you several times each and every day.

 

It’s not a subject usually discussed, particularly with our British reserve over matters toiletary. Just rest assured that help is at hand. Aids exist to help restore your independence in the loo. To restore your dignity. To give you back your privacy. And potentially make going to the loo an experience you look forward to, that actually improves your intimate hygiene.

 

Just push, wash & dry…

http://www.clos-o-mat.com

CHANGING TOILET STANDARDS

‘Best practice’ guidelines on assisted accessible toilet provision have changed, extending the remit to apply to even more locations which people visit.

 

The new British Standard BS8300:2018 addressing building accessibility has just been published. Now, it has expanded on where facilities should be provided, and specifically itemises large commercial retail premises and town centres as venue types that should provide Changing Places Toilets. The expansion supplements the previous advisory venues that include:

– transport hubs,

– tourist attractions,

– motorway services

– healthcare facilities

– cultural centres

– shopping centres,

– key buildings in town centres

– educational establishments

– visitor attractions

– sport and leisure venues, stadia and large hotels.

 

The addition means that most places people go to spend time are now being encouraged, if building or refurbishing, to optimise their accessibility.

The updated Standard has also revised the actual specification of a compliant Changing Places Toilet. It should still be a minimum 3m x 4m, with a ceiling height of 2.4m, and include at the very least a peninsular WC, ceiling track hoist, adult sized height adjustable changing bench, privacy screen, washbasin. Now, however, it is optional whether a shower is incorporated.

 

In our experience, as the biggest supplier and installer of Changing Places Toilets, historically, more often than not, the shower was often omitted anyway. In our experience, in practice, it is the WC, hoist and changing bench that make a life-changing difference to the potentially 14million people who need any or all of the criteria included in a Changing Places Toilet.

 

For anyone who needs either at least one carer, or who can’t get out of their wheelchair unaided, or who has continence issues, conventional wheelchair accessible toilets are inadequate.

 

But it’s not just the disabled person the facilities affect. The same applies to anyone who cares for someone disabled: what happens if the carer needs the loo? Do they abandon the person- be they child or adult- outside the toilet whilst they go?

 

The new Standard comes as the campaign for Changing Places Toilets is enjoying much high profile publicity. The campaign has been featured on national TV, radio and in national newspapers over the past three months. It is being publicised by disabled personalities. It is being discussed in Parliament.

 

However provision of Changing Places Toilets is still, even with the new Standard, still only advisory, the best practice. There are still only about 1000 across the country, 10 years after the concept was first launched. There is no legal obligation to provide them.

 

There is a humanitarian obligation, as desirable under equality, ethical considerations. There is also a strong financial argument to provide them. Government figures claim disabled people spend £249billion a year! 20% of the UK population is disabled.

 

Let’s hope the new BS8300:2018 heralds a new era in developing an inclusive society. Let’s hope other big brands follow the lead of IKEA, JD Wetherspoon, MOTO, Merlin Entertainment, Roadchef, to name a few, and commit to providing Changing Places as far and as widely as practically possible.

 

Next time you’re out and about-whether it is doing the weekly shop, going to the movies, or having a meal with friends-, and need the loo, maybe take a moment to think about how easy it is for you to find, use one, compared to the millions who need a Changing Places. Next time you’re involved in designing, building, refurbishing, remember that thought.

ENDS

* Potential users of a wheelchair-accessible toilet with space, bench and hoist eg Changing Places include:

– 1.5m wheelchair users

– 6.5 million people who have either bladder or bowel incontinence

-1.5million people with a learning disability

– 1.2million people living with stroke

– 62,000 amputees

– 30,000 people with cerebral palsy

– 13,000 people with acquired brain injuries

– 8,500 people with multiple sclerosis

– 5000 people with motor neurone disease

– 8,000 people with spina bifida

– 120,000 people with a stoma

– 100,000 people with muscular dystrophies

– 3.8million adults morbidly obese

– 0.8million disabled children

– 8.7million people with osteoarthritis

– 400,000 people with rheumatoid arthritis

GUARANTEE FOR INDEPENDENT LIVING? INVEST IN PRE-CARE

There are plans afoot for a cross-party guarantee for independent living- in essence, investment in ‘pre-care’ measures to ensure our homes and communities are designed for age and mobility, so that more people are able to take care of themselves and their families at home, for longer.

 

It’s a great plan, but is it just re-working strategies that have already been mooted, for years? Strategies such as lifetime homes, that create a home designed to enable people to live their for their lifetime, with little need for alteration to accommodate decreasing mobility.

There is another interpretation of lifetime homes: that of the cost of adaptation, or providing care. In the automotive industry, lifetime costs already takes into account not just the build and running costs, but the impact beyond- the environmental considerations in shipping parts, and the end disposal. Should we not apply that ‘whole life’ cost to our homes too? How much is the hidden cost of future adaptation, provision of care?

 

It’s not hard to design the home from the outset so that doorways are wide enough for a wheelchair, that doorways are aligned to facilitate later installation of a hoist to help transfer within a room, and from one room to another.

 

But many in the design and build process forget that the one room that is subject to a home adaptation more than any other is the bathroom.

 

And the one area within that room that is most commonly changed in some way is the toilet. It may be something as simple as adding a grab rail, raising the toilet seat height, or changing the seat. Sometimes it is a bigger alteration- like switching the conventional WC for a wash & dry one.

 

There is much focus on the cost of care. Numerous trials have proved, time and again, that effective use of daily/ independent living aids makes better use of available funds, compared to the cost of providing a carer to visit.

There is a hidden cost here too, in providing care support- that of the impact of having a stranger help you on and off the toilet, of having a stranger wipe our bum. What price the feeling of dignity, independence? And what cost to the NHS on treating the mental, and physical, issues, arising as a result?

 

To my mind, any strategy that enables someone to retain any degree of independence is a good thing. We just need a more holistic approach to costs. We need incentives to encourage housing providers, be it in the private or public sector, to design, and build, homes that require little or no major adaptation. We need a view that a capital cost that empowers someone to be independent for even a few months is better- and actually cheaper- than turning to the established method of providing care support.

 

That way, those that really do need the care support, where assistive technology, living aids are not suitable, can benefit, and potentially receive better care from resources that are less under pressure.

FALLING SHORT IN AVOIDING BEING ‘CAUGHT SHORT’

If we need the toilet when travelling in the UK, our ability to find somewhere suitable is now in the lap of the Gods…

 

The Department for Transport Accessibility Action Plan’s consultation process has now closed. Sadly, for the potentially millions for whom a conventional wheelchair-accessible toilet is actually Inaccessible, there was no mention in the original draft of toilet provision.

Fortunately, the Women & Equalities Select Committee, which earlier this year called for greater provision of assisted, accessible faculties aka Changing Places, has taken the matter to heart. Its Chair has written to the Transport Minister calling for them to be considered for the transport network.

 

But therein lies the rub- “considered’.

 

As per the Equality Act, and Building Regulations, there is no insistence. In those two, legal requirements, Changing Places are only “desirable’. Yet without such facilities, people who need help can’t go to the toilet when away from home- be it shopping, or using our transport network.

 

 

Yet, to quote the DfT’s Accessibility Action Plan: “Our ambition is to deliver a transport system which is accessible to all whatever their background or characteristics……There is a need for all who work in the pedestrian and built environment sector to increase their understanding of the needs of disabled people.”

 

Maybe they need to spend the day in a wheelchair, or imagining their have a continence issue. How would they cope?

 

We have said many times before that the law needs to be changed. A truly universal toilet should be the benchmark. Other variants- including separate male, female, baby change- maybe become the ‘nice to have if space permits’.

 

Only then do the toilets become accessible to all “whatever their background and characteristics”.

 

Including an assisted accessible toilet isn’t difficult. If Stoke Bus Station, Port Talbot Station and Portsmouth International Port, to name just a few, can find the space and the will, surely sites with bigger m2, footfall, and £, can do it too?