FACILITATE FUTURE-PROOFING OF HEALTH & WELLBEING

In which sector do you think most of the home adaptations occur? Most of us would probably answer in social housing, for disabled people.

 

Not true.

 

Latest figures reveal that the largest percentage of Disabled Facilities Grants (DFGs) is for owner occupiers, with 70% being for people aged 60+. And the most common room to be adapted is the bathroom.

 

Interestingly, there is a growing awareness of intimate care technology, and the impact of the ‘wellness’ features available. It’s something we’ve been delivering for almost 60 years, in our shower toilets.

 

There is an opportunity to combine the two considerations, to ‘future proof’ at least the toilet in the bathroom, whether you are the home owner, or a developer of supported or assisted living complexes. It can also help deliver part of the Government’s requirement to enable people to stay well and happy at home, with reduced reliance on social care support, as part of its aim to graduate from the Better Care Fund.

 

All it requires is replacement of a conventional WC with a shower toilet. The latter looks like- and can be used as- a conventional WC if preferred. But, either as an improvement on intimate hygiene, or as one’s health deteriorates and wiping with toilet paper becomes hard or impossible, optimum, consistent levels of intimate care are delivered via the integrated douching and drying processes.

 

Such toilets are the norm in Japan for example. If they become the norm here, I am sure we will see a surprising reduction in the number of home adaptations, the amount of care support needed, and an increase in the length of time people can continue to remain in their own homes.

 

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

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.

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

TURN TO TECH TO PREPARE FOR ‘BIG IMPLICATIONS FOR CARE’

New statistics maintain that by 2025 almost 3million over 65s will need care provision, with a quarter of later life spent with some kind of disability(*). Simultaneously, Age UK is alleging that, already, more than 1million people are left to struggle with day-to-day tasks.

Says Caroline Abrahams of Age UK, in a recent article, “There are big implications for contemporary life, including housing, health and care” as a result of our ageing population. Under its Care in Crisis campaign, the charity particularly singles out using the toilet as an issue. Using the toilet IS one of the biggest issues: we go to the loo on average eight times a day!

But it is too frequently overlooked at the expense of the more obvious, less sensitive tasks such as getting dressed, preparing a meal. Think about it: if someone struggles to turn the pages of a newspaper, how can they grasp and tear toilet tissue, and then wipe themselves? If they need a riser recliner chair, don’t they need similar with the WC?

Bear in mind, under the Care Quality Commission guidance for providers, people’s individual needs should be met, and their independence promoted. Premises may need to be adapted to deliver those criteria. And simply phrasing questions with analogies above easily enables identification of toileting as an issue, without offending any personal sensitivities.

Actually, in our experience, once the topic is out in the open, it is welcomed! It’s just not a subject the older generation willingly raise. A more holistic approach to use of budgets could alleviate some of the pressure, enabling people to undertake at least that daily task without help. Think how long it takes care staff to help someone answer the call of nature.

What if, where appropriate, that person was given the tools (aka the assistive technology, equipment) to so do unaided? The cost would be quickly mortised against staff costs. In addition, potentially, once that person no longer needed the equipment, there is no over-riding reason why it could not be re-allocated to someone else, or moved to a different location, to enable another to benefit. For example, a Closomat wash & dry toilet in one en-suite in a care home would be used by all residents who occupied that room over years. A Closomat wash & dry toilet in an individual’s home can be adapted with accessories, at the outset or retrospectively, to tailor it to their needs as those change with time- something that is unique to Closomat. (http://www.clos-o-mat.com/index.php/products/case-studies/88-palma-vita-case-studies/domestic/267-marilyn-carr.html)

One of Closomat’s Aerolet toilet lifters could enable a person to get on and off the WC without help. If in an individual’s home, when they no longer needed it, it could be moved to a different address to deliver the same benefit to another. So even though the capital cost has been recouped, the equipment is still delivering benefit- in effect free of charge! There are further benefits too. By empowering the recipient to undertake something so intimate without help, you enhance their feeling of independence, empowerment, of being in control. All have significant psychological benefits, improving the person’s mental health and thus potentially reducing the need for medical intervention. Such equipment can help them stay in their own home, reducing their need for care support, so you ease the strain on already stretched homecare resources. It alleviates their need for admission to a residential care home, so you ease the strain on the lack of available beds.

James Randall is a case in point: http://www.clos-o-mat.com/index.php/products/case-studies/93-aerolet-case-studies/431-the-best-bathroom-in-the-world.html So isn’t it time we adopted a more holistic approach, to alleviate the potential crisis? After all, every little helps.

 

ENDS (*) The Lancet Public Health Journal

HOW #VALUABLE IS DISABILITY? #STRICTLY SPEAKING, VERY!

There’s a new global campaign to encourage business to tackle disability exclusion around the world- #valuable.

 

The aim is to encourage more businesses to employ disabled people. For many businesses, they see only the problems of employing someone with a limitation, rather than appreciating the potential they have. Imagine if the University of Cambridge had judged Stephen Hawking on his disability?

 

What deters many businesses is the thought of adaptations or alterations they would need to make to accommodate a disabled person.

True, if someone has a mobility issue, there are changes that would need to be made, to ensure they can easily access, and exit, the building, and use it during the working day- right through to answering the call of nature!

 

But those considerations apply anyway. Customers need to access the building. One in five people is disabled. Would any right-minded business deliberately exclude 20% of its customer base?

 

And many disabilities don’t impact significantly on a person’s ability to ‘do the job’. Look at Jonnie Peacock in the latest series of Strictly Come Dancing. He proved that a limitation is often only in the mind.

 

If one puts one’s mind to it, anything is possible.

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.

THE LONG AND SHORT OF INCLUSION

 

 Social- and wider- media has recently seen a flurry of activity around the fact that wheelchair accessible toilets fail to accommodate huge numbers of users.

 

The issue is that there is an assumption that anyone in the wheelchair can transfer from the wheelchair to the toilet and back on their own.

 

We all know what happens when we ass-u-me something…

 

Analysis of wheelchair use shows that around 30% of the UK’s 1.2million wheelchair users do not have powered chairs, and need a carer to propel them. Many wheelchair users also need assistance to transfer. They need their carer to lift them and support them.

Therefore none of those people can use a conventional Document M toilet. It doesn’t give them space to accommodate their carer. It doesn’t give lifting capability.

 

It also doesn’t address the needs of the carer: if they need the loo when away from home, supporting their wheelchair-using caree, what do they do? Abandon them outside?

 

Both of these issues are rarely considered, yet demonstrate yet another reason why the regulations on accessible toilet provision need to be amended. The Changing Places campaign calls for venues to prove an assisted accessible toilet facility with a ceiling track hoist, adult sized changing bench, privacy screen. It says almost1/4million people need ALL of those additional fixtures.

But what about the people you only need one of those additional elements? My point above relating to space the carers and lifting demonstrates instantly that there are a further 360,000 people you need to facilities. That figure doesn’t include their carers. Nor does it include the tens of thousands of people who suffer from incontinence. Nor does it include tall wheelchair users, who may be able to self propel, but once on the loo, because of their height and disability, they can’t transfer back!

 

I am sure if you ask the wider disabled community, they would site numerous other potential uses of one or two of the extra benefits included in a Changing Places toilet.

 

In this age of inclusion, where there is even the provision of facilities for transgender, shouldn’t we first be accommodating the majority? The simple solution is to start with the majority, a toilet facility that accommodates most, and work backwards.

 

The basic provision should be a 12m², unisex, wheelchair-accessible toilet with adult sized changing bench, ceiling hoist and screen. That covers everyone. There is no reason why you can’t provide several of these in place of all the usual, separate, female, male, baby change, and wheelchair-accessible facilities. And it addresses the more “niche” sectors- ambulant disabled, transgender.

 

So by providing g one, genuinely “all inclusive” toilet facility, you open your doors to true inclusion, accessibility.

 

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

WHAT’S ‘REASONABLE’?

It’s reasonable, isn’t it, when you’re doing the weekly shop, out for a meal, that you can go to the toilet, ‘ on site’ if you need?

 

Yet for up to 14million people*, it’s not something they can take for granted. Closomat, Britain’s leader in away from home assisted accessible toilets, reports that one campaigner for these facilities has recently been told that, as there are suitable conveniences within a mile of her local supermarket, it won’t put in those special toilets. So potentially, she has to abandon her shop and leave the store should her son need intimate care attention.

 

Under the Equality Act (which replaced the Disability Discrimination Act), service providers are required to make reasonable changes- including to the built environment- where a disabled customer or potential customer would otherwise be at a substantial disadvantage. Is the situation above acceptable, or does it leave that family at a substantial disadvantage…?

 

That family above is not alone. Estimates indicate conventional wheelchair-accessible (Document M) toilets fail to meet the requirements of up to 14 million people^(*). They may need help to get on, off, clean themselves. They may need to be lifted. They may need changing. That is all equipment provided by assisted accessible toilets, be they Changing Places or their counterpart Space to Change toilets.

The Changing Places campaign states 230,000 people in the UK need these toilets. That figure is based on the number of people who need the support of up to two carers, and need a hoist, and need a changing table, and need a privacy screen.

There are millions of others who need only one or two of those extra facilities and fixtures – for example, a third of wheelchair users rely on a carer to propel them; if you are a carer, the chances are you struggle to lift the person you care for from the wheelchair onto the toilet- you need a hoist. According to the Bladder & Bowel Foundation, more people in Britain suffer from faecal incontinence than suffer from asthma or diabetes, so may need changing facilities. And what about the carer of a disabled person? Are they supposed to abandon them outside the loo when they need to ’go’?

 

Changing Places & Space to Change

Under current Building Regulations, a Changing Places is desirable in buildings to which numbers of the pubic have access. It refers to the British Standard BS8300 for the definition, which, at its core, is:

• A toilet facility in addition to a conventional wheelchair-accessible toilet
• 3m x 4m with a ceiling height of 2.4m
• ceiling track hoist
• adult-sized changing bench
• privacy screen

 

Campaigners for Changing Places have found that many venues say they cannot install the facility because of the required space, and/or the cost of all the additional equipment. Thus, with the support of Closomat, the Space to Change campaign was born.

 

Space to Change bridges the gap between conventional wheelchair accessible toilets and the supplementary Changing Places. Space to Change builds on the Regulatory requirement that says even when only one WC is provided, it should be a wheelchair-accessible toilet. Space to Change asks that just 5m² is added to that standard wheelchair-accessible facility (to give a total 7.5m²), to enable inclusion of an adult-sized changing bench and hoist. Already it is being positively received from retail brands and leading supermarkets, as a viable solution to their ability to accommodate specific customer needs without majorly altering existing outlets.

 

Size Matters

There are specific reasons why those dimensions are chosen. There is a trend towards conceding on the dimensions to ensure the facility is provided, but reduce it too far, and the room becomes unuseable!

 

Campaigners say anything less than 7.5m² means that whilst they can get themselves and their loved one into the room, it becomes almost impossible to manoeuvre the wheelchair and safely execute a transfer to the WC or changing bench.

 

There have also been instances where the ceiling is lower. That has meant there isn’t the necessary clearance to use the hoist to lift the person from the wheelchair onto the toilet or bench.

 

It is therefore sensible to utilise the skillset of away from home toilet providers who can properly assess the potential space, advise on considerations (down to whether the structure is strong enough to load bear the hoist and bench), and ensure the completed installation and compliant in every way- and useable!

 

 

Shout About It!

So often, venues install a Changing Places or Space to Change and leave it at that. Then they wonder why it’s not used.

 

Closomat has developed a package of measures to help venues optimise the facility. In addition to officially registering the toilet, it can provide in-depth staff training, and various signs to help users maximise the facility’s potential.

 

Closomat also suggests it’s sensible to do much more than just put a sign on the door. It proposes:

– Extend signage throughout your premises- perhaps even put something in the window

– Promote it on your website

– Promote it on your social media

– Tell your local media

– Promote it to local wheelchair user groups and other local disability charities- maybe even run special events, discounts for potential users…

 

“If people don’t know about it, how can they use it?” asks Ian Tomlinson, Closomat director responsible for away from home toileting. “Because of lack of appropriate toilets, people who need these facilities either cut their trip short, only go somewhere they know they can ‘go’, or don’t go out at all. The more providers publicise the facilities, the more they will be used.”

 

Toilet provision pays

Regardless of the social/ corporate responsibility aspects of providing such facilities, there are financial benefits too.

 

Disabled people spend up to £249billion a year. Parties with a disabled member spend £12.4billion a year on travel and tourism- a figure that would only increase if they knew they could expect appropriate toilet facilities.

 

Provision of Closomat Changing Places and Space to Change is proven to pay. Alton Towers opened its Changing Places and Space to Change at the start of the 2017 season, and is seeing the facilities used on average 20 times/day, every day.

 

Cornwall Services on the busy A30 trunk road opened its facility a year ago, and is seeing it used on average 10 times/ day, with visitors reporting stopping there specifically because of the toilet.

 

“We are so pleased with the positive response we continue to have: one of the best projects I think I’ve been involved with in terms of the effect it has directly had on guests,” says Justine Locker, Resort Excellence Manager at Alton Towers.

 

Clos-o-Mat is the only UK company with the in-house capability to advice on, help design, supply, install, commission and then service & maintain all the equipment required to create either a Changing Places or Space to Change facility. Its website www.clos-o-mat.com is now the ‘go to’ resource for away from home toilet provision guidance; it contains typical layouts, details of regulatory and best practice compliance, CAD blocks, videos, and white papers.

ENDS

^(*)Potential users of a wheelchair-accessible toilet with space, bench and hoist 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

– 100,000 [people with muscular dystrophies

– 5000 people with motor neurone disease

– 8,000 people with spina bifida

– 40,000 people with spinal injuries

– 120,000 people with a stoma

– 3.8million adults morbidly obese

– 0.8million disabled children

– 8.7million people with osteoarthritis

– 400,000 people with rheumatoid arthritis