When is a Changing Place not a Changing Place?

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A somewhat heated debate has begun regarding Changing Places – toilet spaces which include a hoist and a bench for disabled people.

Partly this is due to two things:

  1. A new type of toilet called Space to Change
  2. Changing Places being built which do not meet the British Standard for space requirements.

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Space to Change

Space-to-Change-Closomat_360_360_int.png A campaign from Firefly, and supported by Clos-o-Mat, is promoting a toilet with a 7m square Space to Change (3m x 2.5m min). This space has a hoist, changing bench and many of the facilities you would find in a regular wheelchair accessible toilet.

The campaign has been going since 2014 and this minimum size and fixtures/equipment is a useful alternative for businesses who just don’t have the space for a Changing Place.

Clos-o-Mat provide more information on this section of their web-site.

They are to “bridge the gap between typical ‘Document M’ accessible toilets and the ultimate, a Changing Places facility”.

It is marketed as a ‘if you have to provide a wheelchair accessible toilet then you might as well add a bit of extra space for a bench and a hoist’.

Advantages

  • This seems very sensible as the reality is that small venues may simply not have space for a large CP toilet layout which has a minimum of 12 m square.
  • Might encourage more toilets to move from Doc M basics to Space to Change.
  • Costs may be less

Disadvantages

  • Not currently referenced in Doc M (will it be included in the future?) unlike CP toilets. CP toilets are mentioned as desirable.
  • Not included in the current British Standard like CP toilets are.
  • Hoist may be a portable hoist – which in this small space, might make it unusable for people with extra large powered wheelchairs and two carers, or moving between toilet and bench via hoist.
  • Large venues like stadiums and shopping centres/leisure complexes might drop down to this small format when they could easily accommodate a full CP toilet.
  • Should not be listed on the CP toilet map – but maybe the map should include CP and STC toilets? I personally don’t want to trawl through two separate toilet maps or lists of different ones held by two organisations to find a toilet.
  • Changing benches do not have to be height adjustable.
  • A large waste bin for pads is not specified aside the regular bin inclusion for sanitary waste and a ‘waste bin’ found in regular toilets.

It is important to note that neither a CP or STC toilet are required within the law for building regulations.

Further debate on the size of installation…

People are spotting toilets included on the CP toilet map which are smaller than the British Standard. It is worth noting that in the early days (prior to June 2013) of CP toilets, the standard was 7 m square – and are included on the map. Many people are getting these confused with ‘Space to Change’ toilets going on the map.

A more recent (2014) installation at Emirates Stadium is said to be smaller than the CP standard yet heavily promoted as a full CP toilet.  From the photos it does look a lot smaller than standard.

For other people, branding is a big issue – some toilets using the CP symbol where no hoist exists and other CP toilets calling them other things like ‘Adult Changing Room’ and ‘High Dependency Unit’.

I have been in small changing places fitted before 2013 – and space was an issue. However, often the layout is poor – space is more about location of equipment not just physical room size. My bathroom at home is fairly small yet I still have room to hoist with carers.

What we found out

So, the debate continues, meanwhile the new British Standards are being looked at and we had the opportunity to submit thoughts and recommendations from our readers and project contributors.

There was a clear need for a range of toilet spaces in size and equipment for small buildings. Also that in larger buildings such as cinemas, stadiums, shopping areas, hospitals, parks/tourist venues and large work places – then even a full CP toilet isn’t meeting people’s needs and that the Standard needs to be raised to support the large number of people who need adjustable toilet risers and washing/drying bidets.

 

 

 

 

 

 

The future of public accessible toilets

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Further improvements are needed if we really want to make ‘away from home’ toilets truly usable for all disabled people. 

The best we have in the UK are those in new buildings which have followed guidance (Approved Document M) on meeting building regulations for access/features etc.

Most places provide single room, wheelchair accessible toilets to the UK wide specified design. A small percentage also provide Changing Places toilets (which take usability a step further by providing a high/low adjustable changing bench, hoist, toilet, sink and larger space). Changing Places are encouraged but not required in buildings. 

However, I feel we need to aim higher – because even these toilets aren’t always usable by a large number of people. It’s not just a case of whether someone can urinate or deficate – it’s about comfort for different body shapes, it’s about safety, dignity and hygiene. All these support people’s physical and mental health.

What might the future look like?

Changes in the law and building regulations.

  • Improved British Standards which would feed into
  • improved design within building regulations, for new buildings (e.g. more space)

Most importantly:

  • New laws on sanitation and equality for public toilets (both around access for disabled people and access for many other users).
  • Laws that make buildings older than 2004 upgrade their toilet facilities to the current specifications to meet duties under the Equality Act (2010) around disability.

*Currently buildings only have to provide disabled access to the level that was specified in the building regulation at the time of the build. Therefore, older buildings will not have the same level of access required today or may have no access at all.

Clear signage

There are so many different symbols, signs and words – which can be confusing for people looking for a toilet. A clear system of symbols would be helpful.

Usage

Promote the proper use of accessible toilets – many people need the facilities but don’t go in because of the words ‘disabled toilet’ or a picture of a person with specific, visual, impairment (e.g. wheelchair symbol/person with a stick). We need more public awareness that toilet like these are for anyone who needs the more specialised facilities inside.

Clearly stating that baby changing should be in an accessible parent/child location would make them more easily available to those with urgency needs.

Use of technology / equipment provision to open up accessibility to more people

Significantly high numbers of people need more than just a standard toilet, shelf and sink to meet their hygiene/toilet needs.

  1. Automatic washing and drying toilets

There are hundreds of thousands of people that are unable to clean themselves easily, or where it causes them great pain or puts them at risk of falls.

  • People with upper body limb loss
  • People with muscle weakness or paralysis
  • People with back problems who can not bend or twist.
  • People with severe arthritis 
  • People with obesity
  • People with dexterity/grip difficulties
  • People with balance and coordination difficulties.
  • People with bladder/bowel disorders/ incontinence
  • People with shortened arms
  • Disabled women particularly during menstruation.

2. Toilets which can be adjusted in height

These are essential for wheelchair users where modern chairs come in a range of heights (and people generally need to be at the same height to manually transfer from chair to toilet etc). Also, people with muscle weakness, neurological impairments or those who have difficulty moving their joints may not be able to stand up from the toilet unless it can be raised up to a height which suits them.

Variable height toilets also suit many lower limb amputees and people with short legs. Adjustability is key to prevent falls and enable people to sit/stand safely and more easily.

3. Sinks which can be adjusted in height

These facilities are only ‘desirable’ and not necessary within current guidance.

Safety

Toilets do not always have none-slip floors or alarm cords. Shouldn’t these be standard in every accessible/adapted toilet?

Space

Did you know that 82% of powered wheelchairs for sale will not fit into the transfer space inside an ‘accessible’ toilet and their is not enough room for assistance (or ambulance staff to get in to help if you fall)?

Increased number of toilets

Large venues like a shopping centre or stadium may have several visitors who need highly adapted toilets – providing one Changing Places is not enough.

What about the cost?

When someone pays for a new building – an office block, hospital, cinema/shopping mall, airport, train station … there is never a question of ‘do we need to put any toilets in the building – because we might not be able to afford it’. It is a ‘given’ that for public health, toilets must be provided. So if a place is going to provide toilets – they need to be usable by everyone (or they are as good as no provision). 

Of course, accessible toilets may have additional costs to ensure the space, technology, maintenance, security etc of the above. Those with an adult changing bench and shower need even more space.

Well, how much do you value disabled people as part of your community or workforce? How much do you want their custom (and their friends/carers/family etc)? How do you put a price on doing the right thing and enabling people to leave their homes and participate in life? What about complying with the Equality Act regarding Disability Discrimination?

Let’s be blunt – how much money are you making in your business – because most of the technology and space adaptations could be done for around £10,000 – £15,000 for the full works and is very affordable.

In my own home I have space, a ceiling hoist and a height adjustable toilet that also washes and dries – for around £5000. 

 

 

 

 

 

 

No toilet = No inclusion

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A simple message for International Day of Disabled People.

I’ll say it again and again and again until the day I die.

How are we (disabled people) supposed to be included and have opportunities to do the regular stuff (work, education, leisure, travel, family life) and stay healthy if we can’t go out because there are no usable toilets we can access.

No toilet = no inclusion = a message ‘we don’t give a &*£@’.

We need things to change NOW please.

Yours Sincerely, a person who can rarely find a usable toilet.


 

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This toilet needs your help

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What if toilets had feelings?

Toilets need your help, today.

Today we bring you a toilet and a sink which have not been treated equally like the other toilets.

Left neglected and abandoned by their owners. No toilet should have to be this way.

They have been incapacitated by the lack of care and maintenance given to the ‘regular’ toilets and if they could ask for your help – they would. They are crying out in desperation.

All they want to do is provide a safe, hygienic place to go to the toilet. A place of comfort and dignity. Many will see only pain, tears and distress. Wrong fittings, missing support rails, cramped spaces … the list is long. All they can do is watch helplessly.

Today a frail elderly man fell because there was no support rail – and no emergency cord to get help.  I felt responsible.

Yesterday a severely disabled little boy had to be changed on the floor, right next to me and the bin. He was too heavy for the baby changing table.  I kept willing him to try not to wave his arms around and touch me because of all the germs. Of course he couldn’t help it. My heart was breaking. I wanted to help. There was nothing I could do. My room didn’t have anything better to offer.

[Anonymous Toilet in Kent, UK]

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People stay at home more where they have fully accessible bathrooms – leaving toilets like these isolated and lonely.


We can change things

Act now and together we can change things. You can do something to help toilets like this.

Customers – tell people what is wrong. It costs you nothing and provides businesses with an opportunity to put things right.

Managers and architects –  offer hope to these poor toilets.  No toilet should have to suffer this way.

Just £67 could buy this toilet room a new tap or fix the existing one.  £100 could enabling local people to fix the flush and understand why it needs to be reachable from the space beside the toilet.

 

 

You could use ‘Euan’s Guide’ cards to remind people not to tie up the emergency cord and take away help from people who might desperately need it.

[We took the opportunity to provide one for the ‘accessible’ toilet at the Fairway pub, Ickenham, Middlesex featured in our video]

Save a life

You could save a life and help toilets provide a safer, cleaner and more dignified experience for their users.

Thank You.


World Toilet Day 2015

World Toilet Day is THE day for action. It is the day to raise awareness about all the people who do not have access to a toilet, and the urgent need to end the sanitation crisis. And it is the day to stand up (or sit down or squat if you prefer) to do something about it.

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.

The bare foot challenge…

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Take a photo (of your feet) standing bare foot on your toilet floor – then share it on social media and add the hashtag #barefootchallenge to join in.

Petition and challenge information 
Nominate friends or do it yourself…. Find out why below.

Why?

Ever stood bare foot on your toilet floor? How about in a public toilet? Not quite so appealing is it? 

I have to be bare foot to be lifted onto a public toilet – so my shoes don’t create more drag. In a public toilet it’s pretty yucky.

Other disabled people have to lie down on the toilet floor for pad changes. 

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 This challenge creates awareness and opportunity to sign a petition of support for change – in the form of more Changing Places toilets. These are toilets with a hoist, changing bench and space. They offer hygiene, dignity, safety and equality.

There are very few of these yet they are needed by hundreds of thousands of disabled people. 

Not what it said on the tin

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Signage is part of a toilet being ‘accessible’. Regular readers will know that generally I don’t seem to be having the best of experiences at zoo’s lately! I came across a problem which, like my recent trip to Bluewater shopping mall, highlighted the barrier that is signage.

Here is a good example of how poor signage can turn a good day into a frustrating one.

I’ll start with Colchester Zoo in Essex.

I saw on their map they had an Adult Changing facility (with a wheelchair logo). This is what their website says: 

* All 13 sets of toilets around the zoo and at our cafes have disabled toilet facilities.

* An adult changing area for those with additional needs is provided at the toilet facilities near the meerkat enclosure. Please ask for a key at the Guest Services office or the nearby Meerkat Hangout cafe.

Whoopee – easy toilet access. The map didn’t indicate a key was needed so initially we found the toilet block and discovered it to be locked. To cut a long story short, we asked for the key, the key had been lost and another was brought over. 20 minutes later…

We opened the door expecting to see an adult changing table a toilet and a hoist. What we found was entirely different – a bed, a small sink and just enough space to go into forward and out backwards in a wheelchair.

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The definition of an adult suggests a person aged 18 or older – someone who, if they need a pad changing, is likely to need carers and a hoist to get onto the bed (and space etc).

This space is a step up from laying a child on the floor (where they are too heavy/long for a baby changing unit) but is really not suitable for changing adults. When staff said the room hadn’t been used that day – I can see why.

So we were left with the regular accessible toilet – which wasn’t accessible because the toilet was in the centre of the wall and with my chair at the side – no space to transfer or sit on the loo. Fail.

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Eventually we wandered around and found a toilet that was usable (I say usable, if you class a very steep ramp to the toilet area that I wasn’t happy going up even in a powered chair as ‘accessible’).  Inside the toilet was better – and thankfully we made it.

Bluewater 

Signage fail number two comes courtesy of Bluewater Shopping Centre in Kent.  I knew they had a toilet with a hoist – but I couldn’t remember where. I looked at the maps and they all just had the generic wheelchair toilet symbol on. I was looking for the Changing Places symbol.

Eventually, after doing a lap of the lower floor, I resorted to asking management to tell me where it was – and we found it with a little label outside the toilet saying ‘HDU’ as in High Dependency Unit. I know some people prefer this term as opposed to ‘Changing Places’ (it is a registered CP toilet here) but it confused me.

I thought it was key operated (a sign mentions getting a key) but today the push button door opening switch was half working.

It wouldn’t let you in but once in, the internal button did close and auto lock the door. To gain entry you could force slide the door open (no handle of course!).

The problem was, inside there was no curtain, so I sat on the toilet, opposite the door, whilst my assistant went outside to give me some privacy – only we didn’t realise the door was so slow ….. the 40 seconds it took for the door to open and close felt like an hr.  Not the best experience!