Draft of BS 8300 -2 available for comment

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British standards are helping businesses thrive. Some of them define access for disabled people outside and inside public buildings.

What is a British Standard?

Standards define best practice in many different areas. They’re put together by groups of experts and come in a number of different kinds, from a set of definitions to a series of strict rules. 

… Standards are not the same thing as government regulations, but they’re often used in legislation to provide the technical detail.

(BSI, 2017)

Standard BS 8300 defines access requirements from ‘set down points’ in car parks to the distance to the toilet or width of lifts. There is a section about toilet access, dimensions, fixtures, fittings etc which is best practice. 
A new draft for BS 8300 is available to read and comment on. There are two parts – the toilet section is on 8300-2.

Link to draft BS 8300-1 and BS 8300-2 (enter 8300 in the search). 

Gender neutrality and accessible toilets

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Accessible_toiletSo for the last 6 months or so there has been much discussion on gender neutrality and which toilet you use.

Followed by ‘if anyone can use a toilet, what sign do we put on the door’.  Oh my goodness – do you put a man and a woman, both, half and half, something totally different …. or maybe just a picture of a toilet would be pretty sensible?

Whilst the world goes crazy trying to figure this out …. accessible toilets have been caught in the cross fire.

Our ‘unisex’ toilets don’t have any gender specific symbol

gender_wheelchair_toilet.jpgYou see, we never had any gender identity to begin with. Someone thought ‘we’ might be best represented by a genderless person, usually with no neck, sitting rigid (probably because they sat on a broom handle or something)  in an odd shaped wheelchair.

If we had gender then wouldn’t we have had this toilet sign?

 

 

We don’t think – is this representing a man, woman etc to decide whether to go in or not …. we just see the symbol, on a single occupancy room, and know that beyond the door is a toilet which is hopefully surrounded by adaptations and space to use it.

This symbol isn’t even toilet specific – it might not be a toilet behind the door it could be an ‘accessible’ anything because this is just a universal symbol for access in relation to disabled people.

Not only genderless but not representative

One of the issues is that this symbol doesn’t even represent three quarters of the people who can use an accessible toilet – anyone with a medical condition who needs the adaptions or quick toilet access.

It doesn’t represent people who have an impairment but don’t use a wheelchair. It’s also a major barrier for people who think the symbol represents disability and they don’t identify with being disabled (e.g. older people, people with IBS and mental health problems often do not define themselves as disabled and feel the toilet is for ‘others’). How do you get over that?

Do we need a totally new, universal accessible toilet symbol – and how on earth could we pick something meaningful to everyone. This has been the problem and reason why most countries stick to keeping the symbol of a wheelchair user.

Why this symbol does not make it the designated gender neutral toilet.

Because of the rise in people speaking out about needing a toilet that is gender neutral, some businesses are saying ‘ we already have a toilet just for you [points to the accessible toilet].

This is not a toilet for ‘anybody’ to use … if people don’t have an impairment then they shouldn’t be taking up a toilet with adaptations.

People looking for a gender neutral toilet don’t want to be taking up facilities that are for disabled people. It’s awkward and discriminatory, all round. People just need a toilet. One with adaptations and one without. It’s simple.

Disabled people might need quick access to the toilet because of their medical condition (and may need to go more frequently and stay longer). Every ‘other’ person (be it a parent needing baby changing or a transgender person etc) is taking away the accessibility feature of ‘availability’ every time they use it.

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I sincerely hope that we don’t start seeing this sort of thing become the norm. A sign to represent a gender neutral toilet – attached to what used to be an accessible toilet only for disabled people. I am hearing that this is starting to happen though and it’s worrying.

This will cause so much distress to disabled people who need quick toilet access but may now have to wait because the toilet has been opened up to anybody – all because of a sign.

 

 

Launching our new campaign

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Today we launch our new campaign #BiggerIsBetter [Bigger Is Better].

We hear over and over again how much people struggle with the size of wheelchair accessible toilets.

Unfortunately, the size suggested by building regulation guidance is far too small for the types of wheelchairs and scooters that people use today.

We need to raise awareness and explain why meeting  building regulations does not mean they are meeting their legal duties to provide usable toilets under the Equality Act [Disability Discrimination]. Very few businesses are aware of this.

Wheelchair users can often not get into these toilet spaces, turn around or transfer safely. They become unusable. An unusable toilet might as well not be built.

Every toilet that gets built to this size could mean decades of  being unable to use that toilet. If nothing happens now – the future will remain bleak.

If the standards are not going to change, then the only way forward is to reach out to as many businesses and new developments as possible and encourage them to see that bigger is better.

 

We need to encourage larger spaces and where possible Space to Change or Changing Places. Without larger spaces, wheelchair and scooter users will continue to struggle to live as equal citizens in the UK.

Please join the campaign and help spread the word. Share our posters, pictures and your experiences.

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New report: Toilet access within the NHS

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Disabled people of all ages, and those who support them, are putting their health at risk because of lack of usable toilets within NHS hospitals and clinics.

Inaccessible toilets at UK hospitals and clinics are also having an impact on the health and recovery of people who may not identify themselves as a disabled person. People with dementia, bowel/bladder disorders, those receiving treatments for cancer or heart/lung disease, rehabilitation therapies or mental health illness for example.

Our 43 page report with a summary of key findings (below), brings together the experiences of patients and families.  

Contributors all have a long term health condition or illness which makes it difficult or impossible to use the toilets currently provided. 

Download the report from the link below.

NHS Accessible Toilet Report 2016

We a very grateful to everyone who participated, providing much needed insight of the urgent need for equality of toilet provision, within the NHS, to support physical and mental wellbeing.

 

Key findings 2015-2016

Stigma

  • Due to stigma, embarrassment and sometimes cultural or gender reasons, patients and visitors rarely complain about difficulties accessing/using the toilet or sharing their experiences.

Rights and Equality

  • Provision of toilets are the most overlooked Human Right contained in the European Convention on Human Rights and the UK Human Rights Act.
  • Access to sanitation is a Human Right being ignored within the NHS.
  • Equality Act duties are not being met because a worse standard of toilet provision is provided for disabled people with no reasonable adjustment.
  • Patients who do not meet the Equality Act definition of ‘disabled’ are also affected by lack of facilities due to short term illness, injury etc.
  • NHS buildings are failing to meet building regulations or strive for British Standards. 
  • Standard wheelchair (Approved Document M ) accessible toilets are not meeting the health and sanitation needs of a wide range of people, particularly those with:
    • Obesity
    • Muscle weakness / neurological impairments
    • Spinal injury
    • Stroke related difficulties 
    • Limb loss
    • Shortened limbs
    • Arthritis  / joint immobility
    • Dementia
    • Diabetes
    • Urinary Incontinence including urgency needs
    • Bowel Incontinence  
    • Learning Difficulties
    • Brain injury and balance disorders.

Safety concerns 

  • Some toilets have been found to be unsafe e.g. by not using non-slip flooring, no emergency cords / unreachable cords or not having the right type and placement of support rails. 
  • Hospitals are failing to ensure dignity, safety and well being of patients, staff and carers by offering unsuitable alternatives to standard toilets.
  • There are 155 acute NHS trusts plus 56 mental health trusts as of October 2015.  Many having multiple buildings across several locations.   Out of all these buildings, only 42 provide a basic Changing Places toilet with hoist, extra space and bench access.
  • NHS staff, for the safety of themselves and patients, can not assist by lifting people from wheelchair to toilet or from a seated to standing position. Where Changing Places are not provided or other suitable equipment such as adjustable height toilets, patients must take a family member to do manual lifting/assisting. This has caused long term back pain for many carers and is painful and dangerous for those being lifted.

Poor signposting

  • NHS staff are not familiar with the needs of patients regarding sanitation which results in poor signposting to toilets / inability to locate a toilet and unsuitable ‘alternatives’ being offered.
  • Not all toilets are shown on hospital maps/signs – and the facilities in each are variable, resulting in difficulty locating a suitable toilet.
  • Very few NHS websites detail information about where toilets are located and the facilities in each – making planning for an appointment difficult.
  • Toilet signs are often difficult to understant, see or follow.

General Health and Wellbeing 

  • Women are worst affected due to the need to be seated on the toilet, menstrual hygiene needs, increased risk of urinary infections and being more likely to have bladder problems such as urgency.
  • Patients say they would rather miss appointments because of fear of not having toilet access.
  • Families are prevented from visiting their spouses/children or friends in hospital because they can’t access a suitable toilet.
  • Patients are choosing to stay at home rather than go to A&E where long waits and no usable toilets are normal.
  • Patients are having surgery to remove the need to sit on a toilet (ostomy or suprapubic catheters)  because of access reasons not because of a medical need.
  • A healthy adult empties their bladder every 2-3 hours, yet many disabled patients are avoiding food and liquids for several hours because they know they can not use toilets at hospitals and clinics.
  • Avoidance / withholding urination and defecation has caused kidney, bowel and bladder damage.
  • Patients are taking extra medication to prevent urination or defecation when outside their homes for several hours impacting work, leisure and attending health appointments/treatments.

Difficulties specific to wheelchair and Scooter users

  • Wheelchair and Scooter users can not get close enough to the toilet for safe transfer. (People with a wide gait, obesity, users of frames/walkers or crutches are also affected by this space restriction).
    • 82% of powered wheelchairs will not fit into the transfer space at the side of a toilet that meets current building regulations.
  • Out of 613 models of scooter and powered wheelchairs – only 140 can turn around in the turning circle recommended in the current building regulations.
  • Severely disabled patients are spending several hours in soiled pads whilst they attend hospital appointments because of no hoist or changing bench facilities.

 

The NHS, by its very nature, will serve a higher percentage of people who need very specific facilities to use the toilet. Therefore, adapted toilets need to be of a higher quality to maximise independent toilet use and maintain a high standard of dignity, safety and hygiene compared to other ‘away from home’ facilities.

Due the nature of a persons’s impairment, illness, injury or medical condition, they may:

  • need the toilet more urgently
  • spend longer on the toilet (and getting on and off the toilet). 30 – 40 minutes is an average time.
  • go more frequently
  • require furniture/equipment to aid removal of clothes e.g. bench/chair
  • need toilet provision beyond what is required within building regulations e.g. extra space, access to bidet facilities/washrooms, access to a hoist and changing bench, access to a height adjustable toilet or other equipment.

To substitute a dedicated room (that non-disabled people are provided with) which has a flushing toilet, sink, waste bins, toilet paper, privacy (locked door/single person use) and space for any of the following (which are common practice alternatives) is not appropriate and probably unlawful.

  • offering no support or equipment – no usable toilet.
  • offer of a commode, spare bed / cubicle (often with a wait) alternative for people who could use a toilet room if one was provided.
  • suggesting patients pre-arrange hoist and nursing support (where space exists to safely use these as a hoist can not be used in a standard wheelchair accessible toilet space). Few people know exactly when they will need the toilet to plan days in advance.

Many alternatives cause pain, embarrassment, and mental distress. Solutions exist because people are able to use the toilet in their own homes – so why not in hospitals and clinics?

Equality of toilet provision – The Equality Act 2010

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Whilst not a legal guide, information is provided here, and in our guides, to help you assess if your toilet provision is meeting the required standards and your Equality Act duties. Only a court can decide if you have failed to prevent or caused disability discrimination.  Similarly, toilets which do not comply with health and safety will be subject to further actions and investigation from relevant safety bodies.
Guide to Accessible Toilet Standards and Equality Act Requirements

The Equality Act 2010

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In the UK, the Equality Act protects the rights of all disabled people, as individuals – which includes sanitary facilities that are provided.

Facilities being offered must provide equal access to toilets for disabled customers / visitors and employees, to the same standard as non-disabled people.  This means meeting their Equality Act 2010 obligations. Public bodies such as councils, schools and hospitals have additional duties under human rights law and the Equality Act.

The Equality Act does not recognise ‘minimum standards’. An individual disabled person or carer could argue that there has been no ‘reasonable adjustments’, as required by law, as it relates to them.  Also, what is ‘reasonable’ changes over time and adjustment is an ongoing obligation.

Being Reasonable

A business should pay close attention to how ‘reasonable’ is judged in courts and described in the Equality Act. Many businesses underestimate the extent of their duty to make adjustments and do what is reasonable in all of the circumstances.  Citing ‘too expensive’ or ‘disruptive’ without evidence of a thorough assessment and providing strong reasoning would be unwise.

Making adjustments

Businesses must take positive steps to remove barriers to disabled people and make reasonable adjustments. They must think ahead and plan to remove barriers – not wait until a person has had difficulties or feels they have been discriminated against.

Listen to the experiences of disabled people and if a problem has occurred take reasonable action to prevent discrimination from re-occurring in a timely manner – the ongoing obligations of the Act.

If someone doesn’t cooperate with their duty to make adjustments, the Equality Act says it’s unlawful discrimination.

The duty to make reasonable adjustment, imposed by the Equality Act 2010, means that provisions beyond that in Approved Document M [AD M] of the building regulations are likely to be required to anticipate the needs of a range of disabled people so they have equal toilet access.

You may have to upgrade your toilets now rather then wait for a ‘refit’ or new toilet block to be built.

Reasonable adjustments may include:

  • Gaining a thorough understanding of the needs of a range of different people and understanding particular needs e.g. asking “what do we need to do specifically for people with profound and multiple learning difficulties” as opposed to ‘what facilities do disabled people need’ or ‘what is the minimum standard we have to meet’.
  • Auditing toilet facilities thoroughly – not just against minimum standards.
  • Consulting with disabled staff, customers or other organisations to ensure facilities meet a wide range of people with different hygiene needs.
  • Making physical adjustments / building new toilets.
  • Providing Changing Places toilets or hiring a mobile unit
  • Publishing access statements about toilet facilities.
  • Making people aware of the type of facilities you have (e.g. widths of doors, heights of toilets, layout of grab rails, type of lighting etc).

What do the building regulations say?

Although the guidance in this Approved Document, if followed, tends to demonstrate compliance with Part M of the Building Regulations, this does not necessarily equate to compliance with the obligations and duties set out in the EA [Equality Act].

This is because service providers and employers are required by the EA to make reasonable adjustment to any physical feature which might put a disabled person at a substantial disadvantage compared to a non-disabled person.

In some instances this will include designing features or making reasonable adjustments to features which are outside the scope of Approved Document M. It remains for the persons undertaking building works to consider if further provision, beyond that described in Approved Document M, is appropriate.

[http://www.planningportal.gov.uk/uploads/br/approved-documents-amends-list_2013.pdf]

How do I upgrade my existing toilets?

cp_doorTo provide good facilities the following types of venues (but not inclusively) should be looking at 1 or more Changing Place toilets alongside provision of toilets that meet the latest building regulations (October 2015) – these have diagrams of exactly how to fit out a toilet, what size it should be etc for maximum accessibility.

  • major transport terminals or interchanges such as airports, large railway and bus stations
  • motorway service stations
  • sport and leisure facilities, including entertainment arenas, stadiums, large hotels, large theatres and multiplex cinemas
  • cultural centres such as museums, concert halls and art galleries
  • shopping centres, large retail developments and Shopmobility centres
  • key public buildings within town centres such as town halls, civic centres and principal public libraries
  • educational establishments, including universities
  • health facilities such as hospitals, health clinics etc.
  • portable facility at outdoor events

There is also a British Standard for accessibility BS8300:2009.

Guides on our link/resources page will also help you.

Full details about Changing Places and are available from:

http://www.pamis.org.uk/cms/files/publications/Changing%20Places%20a%20Practical%20Guide.pdf

Smaller venues should look at recent building regulations below and also look at whether other facilities could be offered e.g. a hoist or a changing bench for disabled children if they can not provide a Changing Place.

http://www.planningportal.gov.uk/buildingregulations/approveddocuments/partm/adm/
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If toilet facilities are not meeting the needs of individual disabled people, organisations must change things to make sure there is suitable toilet provision. Not having useable toilet facilities would be a major barrier to using / visiting , or working for an organisation.

Having no usable toilet facilities is also highly likely to prevent substantial income generation from disabled people and their families because they would be unable to visit, or visit for the same length of time as non-disabled people might.

Unpicking the news: Paul Vice, amputee, refused access to the toilet

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So, a few days ago, this story appeared in the Plymouth Herald.

http://www.plymouthherald.co.uk/Disabled-Plymouth-war-hero-refused-access-toilets/story-28054407-detail/story.html?

Summary of the story

Mr Vice went into a sports centre and requested to use the toilet. He was refused because staff said members of the public could not use it. He then requested use of the disabled toilet, receiving the same answer.

In the news article we are told that he lost his leg and experienced several wounds whilst serving in Afghanistan.

So this raised some questions in the comments section which we can look at below.

  1. Rules are rules

The majority of responses indicated that, disabled or not, if the rule is that toilets are only for people using the sports centre, then the refusal is appropriate. This is a valid point – but sometimes rules need to be broken for the sake of compassion – a human being was in desperate need of the toilet!

2. Disclosing impairment 

Staff did not know if a) he was disabled or b) what the nature of his impairment was. They had no way of knowing because the majority of impairments/medical conditions are not visible.

If they had asked ‘are you disabled’ or ‘why do you need to use our toilet’, that would also have been rather insulting and embarrassing – but lots of people do fake impairments just to get quick access to a toilet.

Staff are stuck in a no win situation – unable to ‘determine if he genuinely needs the accessible toilet on compassionate grounds and the need to keep toilets free for use by disabled customers using the sports centre.

Should he have explained he was disabled?

Mr Vice felt they didn’t need to know about his leg. If he had explained he was disabled, would that have got a different response? Well, possibly not – if we stick to the ‘our customers only’ rule. However, in terms of disability equality and human kindness – a disabled person might have very few toilets they can use compared to other people and have to resort to such requests. Others may have impairments which cause them to suddenly need the toilet without warning – and it would be inhumane to make someone pee in the street.

We know that Mr Vice can use toilets without adaptations – as these were the toilets he originally requested. Therefore he will have the same access to toilets in other locations as non-disabled people if refused entry.

We do not know whether his injuries have also caused bladder problems – but there are ’emergency’ cards which can be carried to discretely show to people to explain the need to quickly use a toilet.  People can then offer toilets on compassionate/medical grounds to those with urgency problems or similar.

Conclusion

The story highlights the dilemma of staff who have toilets for ‘customer use only’.  However, on compassionate grounds for human beings in need of the toilet, perhaps they should have let him go – because he is human and not because he is disabled.

Sanitation and the purple pound

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If disabled visitors can pee and poo, the purple pound will come to you.

It’s that simple.


Sanitation is possibly the most overlooked provision that can bring profits down and decrease the number of visitors you will attract.

When asked what is the biggest factor that would prevent or deter you from visiting an attraction – disabled people generally say it’s the toilet facilities that influence their decision the most.

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A toilet that fails disabled people

Let’s face it – would you visit somewhere for the day that had no toilets?

We need to remember that an ‘accessible toilet’ that is not usable (or doesn’t have the full compliment of access features for people with different needs) can be regarded as absent.

Your toilet is as good as absent if:

  • it is poorly signposted. If you can’t find it when you need to – it might as well not be there.
  • locked (aside NKS keys)
  • has the wrong fixtures and fittings
  • poorly maintained (dangerous, wrong flooring, poor illumination, wet etc)
  • cluttered or being used as storage space
  • Does not have the full range of access features needed by visitors – would you know what makes a toilet usable for all?

I have been to 14 places of interest in the past year (Museums, gardens, historical buildings, wildlife parks/zoos, heritage railways) for days out.  Being passionate about sanitation, I looked in every ‘accessible toilet’ on all but one site  – not a single one met the full access requirements as detailed in the current building regulations for a new toilet.

In other words, they all had elements which would have made them unusable for people with particular needs.

Only 2 had a hoist for people who can not raise themselves out of a wheelchair onto a toilet, and only 1 had an adult changing bench for those who need a pad change.

I have what is required by law.

This may be true in respect of building regulations – but the Equality Act 2010 requires equality of sanitation provision for disabled people. (See our free guides for information)

To fail to bring your facilities up to the most recent standards gives a strong message that disabled people and their friends and families are not welcome. You are not interested in supporting social inclusion and are not interested in taking your share of the purple pound.

What is the Purple Pound?

The purple pound is money that disabled people and those that come with them (e.g. family, friends etc) have to spend on tourism.

  • In 2013, 20% of all Tourism Day Visits in England included someone with a health condition/impairment. That’s a spend of £9.4 billion.
  • Over 500,000 people each year visit England from abroad, who also have a health condition or impairment – worth £341 million.

In total – disabled people and companions are spending £12.4 billion pounds a year within tourism.

Why would you not want some of this money?

The quality and standard of your toilet provision says a lot about you. Get it wrong and it’s going to cost you money and your reputation.

Written for World Tourism Day 2015:  http://wtd.unwto.org