Research shows that even today, too many buildings are difficult to access for adults with impairments 54% of shops, 34% of hospitals, 23% of bars and restaurants and 17% of people surveyed cited bathroom facilities as the most common barrier for accessing a building. (Papworth Trust Disability in the UK Facts & Figures).
A Changing Places toilet, and its counterpart hygiene room, is for people who need the help of a carer to toilet. Bigger than a conventional, wheelchair accessible toilet, it has, as standard, an adult sized, height-adjustable changing bench, hoist and privacy screen. Many exceed the basic specification and incorporate a shower, and/or an automatic shower (wash and dry) toilet. Without any of this equipment, campaigners say they either have to curtail their trip, or have to change those they care for on the toilet floor. Getting the specification right plays a huge part in the overall success. Its great if the facility can be designed into the initial plans, but many are retro-fitted.
Because they include hitherto rarely-installed equipment such as height-adjustable changing benches, hoists and height-adjustable washbasins, Changing Places installations are often perceived to be difficult to install, and important, and often basic, issues are not even contemplated.
It may be an obvious point, but a Changing Places room is still a toilet, and therefore needs all the associated ancillary services water, electricity and drainage. The electrical services require appropriate protection, in line with current regulations, to power the hoist, height-adjustable equipment, a shower and hand drier. The electricial, waste and water services need to be recessed into the wall, not surface-mounted/run. Hand driers need to be positioned at a height to suit someone in a wheelchair and, for the same optimum inclusivity reason, be downward blowing.
Stud walls will not suffice. Walls need to be load-bearing, as they have to carry not only the equipment, but the additional weight of an adult using the equipment an adult who could be bariatric. Brick and block is the most appropriate construction. Alternatively, a mobile bench overcomes the need to potentially strengthen the wall.
Ceilings need to be high enough at least 2.4m to allow the ceiling track hoist to function properly, and suspend the user safely above the floor. If height is an issue, specify a floor, mobile hoist, but beware that non-fixed equipment can go walkabout.
Preferably, washbasins should be height-adjustable with concealed plumbing. The height adjustability enables its use by mobile and wheelchair-bound alike. Concealed plumbing is a must imagine the scenario where someone gets their wheelchair tangled in the exposed plumbing at best, the pipe may break, at worst, a litigation suit. Taps on basins and showers need to be DDA compliant, ie thermostatically controlled to prevent scalding, and able to be operated with a closed fist.
Flooring should be non-slip, and matt. But there are fun considerations in specification and construction too. Colour is vital. Most sanitaryware is white, and there is a tendency to go for neutral background colours. But if you have a sight impairment, you want big bold colours, to help you navigate: purple walls are excellent, a strong blue is widely acknowledged as a key colour for toilet seats and similar equipment.
Once installed, the equipment should be commissioned, and then serviced annually, with a LOLER inspection scheduled twice a year. Service and maintenance contracts provide an efficient solution, giving peace of mind and the assurance that the toilet facility is properly operational regardless of frequency of use.
All of this may sound obvious, but from practical experience, it isnt. The key is to communicate with all parties involved throughout the process, and use available expertise to ensure the initial design is right, and then that it is all implemented properly with due consideration to any modifications en-route.
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