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. 

 

 

 

 

 

 

Share your experience tool kit – challenge discrimination

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Our new guides and ‘Experience form’ make up our new tool kit to challenge discrimination.

The tool kit is available for disabled people and their assistants / carers, to enable them to approach a company who has failed to provide accessible toilets that meets their needs.

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It can be the start of a conversation to challenge discrimination and provide business with an opportunity to explain their approach to equality in the area of toilet access / sanitation / hygiene provision.

 


 

Step 1:

If you have had a bad experience, either download our form (or copy and paste the text into an e-mail).

The form (and a link to a text version to copy and paste) is available from: Links and resources page

Step 2: 

To fill out a pdf. form, use the ‘text’ and ‘highlight’ functions on your pdf viewer, save it and attach it to your e-mail.

  • Even easier is to create a new e-mail, and copy and past the text straight into it  from here.

 

Completing the form:

Once you have completed your basic details, go through the list of statements in the following 10 topics:

  1. Finding and entering the toilet area
  2. Entering / securing the toilet room
  3. Inside the toilet (space/colours/lighting/equipment)
  4. About the toilet / bench / hoist
  5. Sink
  6. Accessories (e.g. mirror/dryer etc)
  7. Horizontal support rails
  8. Vertical Support rails
  9. Emergency cord
  10. Other

simply deleting the ones that don’t apply – or highlighting the ones that do.

don’t forget to attach any pictures of the toilet you had difficulties using – this is important evidence.

Step 3 – Understanding the company response

The person may respond with a general statement like ‘… we do our best to make our venue accessible and will look into it’. In which case,

  • reply with a reminder to ask if they can let you know what they found out
  • ask about what they intend on doing and
  • when you might hear back from them.

Another type of reply might be something like ‘we have already complied with Document M and provide accessible toilets’. In this instance, you may want to read and supply the company with one or more of our guides, pointing out that meeting Document M guidelines does not mean they have met their duties as required by law within the Equality Act 2010 – and that the toilets did not meet your needs.

If you are unsure what these mean, our guides will also help you understand these standards and equality law.

Our guides to support you and the company include:

You can view the contents of these by clicking on the above links. They can all be downloaded from our links and resources page.

Step 4

If you are not happy with their reply you could consider continuing your discussion with them or you could consider sharing the communications with an advisor or legal expert to explore the option of taking legal action and the costs which might be involved.

Other options might be to contact your MP and explain the difficulties you have or consider a social media or local media campaign.

Remember, you have the right not to be discriminated against and treated differently when it comes to public toilet provision or as an employee who needs accessible toilets.

Guide 2 – What makes a toilet accessible?

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Our second guide can be downloaded from: links and resources page.

What_makesWhat makes a toilet accessible? An introduction to the needs of disabled people and assistants/carers.

A 30 page guide providing a brief introduction into the facilities that should be provided in a public accessible toilet to ensure dignity, safety and equality of toilet and hygiene provision.

We hope you will find the information useful if you:

  • Are passionate about improving the accessibility and usefulness of toilets for disabled people.
  • Wish to raise discussions with a business concerning a difficulty you have had accessing or using provided toilets.
  • Are building a new toilet or upgrading your existing facilities.
  • Are responsible for the maintenance or cleaning of sanitation facilities.
  • Are designing or submitting planning applications involving a new accessible toilet or altering existing ones.

 

Contents

About this Guide
Contents
Toilet types and signage
Three types of toilet
Legal requirements
Disability Equality
Building Regulations and British Standards
Health and inclusion
What should I find in a new accessible toilet?
Unisex, individual accessible toilets.
Changing Places toilets using BS 8300 (2009)
Accessibility features
Door entry and locking
Lights and accessories
Toilet height and seat type
Washing / drying toilets
Other accessibility features
Examples of a stylish toilet that is not accessible
Sinks and their function
Use of toilet paper
Facilities for people with bladder and bowel disorders
Availability – an important part of accessibility
Provision for people to manage their bladder/bowel
People who have an ostomy
Using the toilet whilst standing, or sitting in a wheelchair.
People who use a hoist
Needs of Carers / Assistants
People with other needs
Privacy
Stigma
Thank you to…

 

*AD M = Approved Document M.  This is available from the official planning portal web-site [http://www.planningportal.gov.uk] for the most up to date information and documents.

Novamed’s unique bed hygiene / toilet system

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Novamed_Europe_-_Better_SolutionsNovamed Europe are our guest bloggers this week with their innovative hygiene / toilet solution – Solaticare .

For full information and a brochure visit: http://novamedeurope.com/products

or you can chat with them, about their product directly or over on our Toilet Talk   Face Book group.

Solaticare

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Solaticare is an exciting new solution for those who are unable to access toileting facilities independently, once in bed.

It promotes dignity by allowing the user an independent solution to the need to eliminate, although a carer may also assist in the process.

There are two options – an automatic version located in the workings of an electric bed, and a community version, which uses a specially adapted mattress placed on a standard bed, with the help of a carer.

How you use it

To use the hospital bed model, the user needs to be lying supine, without pants, sheets may remain in situ. Using the remote control, the process is initiated with the press of one button. The mattress infill moves down and away, the Solaticare suction head then rises through the mattress to its working position, in very close contact with the body. When the user urinates and/or defecates into the suction head, the sensors within the suction head will remove the waste into a hermetically sealed unit next to the bed, once this has finished, rinsing with warm water follows, and the process finishes with warm air to dry the skin. The in-built catalytic deodorizer neutralizes any unpleasant odours. Then the suction head returns to its original location, and the mattress infill returns to give a comfortable feel to the bed.

The community model requires the help of a carer to positon the suction head with its hoses in a specially designed mattress cut-out, prior to use, and then it needs removing at the end of the process. There are infill pieces to restore the mattress integrity.

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Hospital bed model

The extraction unit is located by the bed stores the clean water and waste, emptying/refilling is needed usually just once a day. The process can also be controlled from the control panel on the extraction unit. This also includes controls to personalise settings, as times and temperature can be altered to suit personal preference. There is also a voice prompt option which tells which process is in function. It also comes with an optional shower hose which helps patient shower whilst in bed.

What do you think?

It’s finally arrived – the Aquarius Porta Bidet

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I’ve been waiting a few years now for this product – and had given up all hope – then today I noticed it had arrived and was ready to purchase ….. so here it is – the Aquarius Porta-Bidet.

Aquarius

Retailing for the VAT exempt price of £195 (free carry case if you order now worth £25) this might be just what you are looking for – (Pre-order price secured with a £50 deposit until March and free entry into a draw to win one for the deposit price).

I’m excited because the chances of finding a toilet that a) I can get on to and b) has a bidet feature, on holiday, is almost nil.  However, It’s the thing I love about coming back from holiday – oh how I miss my bidet!

So what has this to offer. Well, it’s battery operated which claims a powerful pushing wash nozzle and it gets the water from a reservoir container you place on the floor (so no plumbing or tampering needed).

Let’s look more carefully.

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This is a screen shot from their video on: http://www.aquariushygiene.com/2014/11/14/the-all-new-aquarius-porta-bidet/

I have a portable spray unit like this that fixes just under the lid – which I bought to make my own portable bidet. My unit came from South Korea and cost about £25 …. but pumping water through it was going to be the difficult part … so let’s see how Aquarius Hygiene do it. Interestingly (and somewhat annoying for me) they can bulk by I assume and offer this part as a replacement ‘spray arm’ for only £9.95.

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Again, I have taken a screen shot – you fill the unit with water and it has a built in pump and an on/off switch on a tethered handset (which has a hook if you want to hand it nearby). The nozzle retracts after use (and whilst I couldn’t find details on the nozzle spray unit they used – I assume it has a hygiene ‘rinse through’ to keep the nozzle clean?

The unit is a pleasing aqua green and white colour – no information on how big but here are further details:

  • It uses rechargeable batteries
  • 1.5 Litre capacity
  • Minimum of 50 wash cycles per charge
  • 4 wash cycles per reservoir
  • Under 2kg in weight.

The nozzle is not adjustable – so you get the spray wherever it lands (I know this will be problematic for me because of the way my pelvis ‘sits’ – so if you can’t sit right back on the loo or have pelvic deformity where you don’t sit ‘evenly’ you may just get a wet thigh instead. For me, some water is better than no water!

I’m pretty sure to be getting one – so I’ll give it a full review in the summer when I’m on holiday.

Until then…

Dignity down the pan – does it have to be this way?

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It might be a quaint way to describe a lavatory but how I wish bathrooms weren’t the ‘smallest’ room in the house. You can hardly swing a cat in most of them and if you have restricted mobility, then what are you supposed to do….

Time to do some myth-busting and explore the nemesis for wheelchair users that is The Loo.

 

1. Wheelchair users don’t need to pee (or poop).

They probably have catheters or something and pee into a bag or wear incontinence pads? Do people really think that is what happens – and they don’t need to provide accessible toilets? I was once approached by a complete stranger and asked ‘do you use a catheter’. It is bizarre, rude and ignorant – but it happens.

Yes some people do but not everyone – most of us pee and poop the way nature intended and need to get to the loo. Even people with catheters and bags that hold the urine have to be emptied – so we all need a toilet.

2. Disabled people poses super powers to hold themselves for several hours at a time and don’t need a toilet.

Daniel Baker

My friend Daniel Baker at MCM Comic Con – so maybe people do have super powers?

I certainly don’t poses this power and I doubt anyone else does.

If I drink, inevitably I will need the loo at some point. If I drink tea then you’d better have either a toilet or a mop to hand – your choice.

Seriously though, I can’t visit anyone’s house without resorting to only having a sip of water before I go, and nothing until I get home. I can’t risk needing the non-existent loo so my favourite cup of tea has to go on hold.

I use a small adult power chair – but bathrooms in people’s houses are either upstairs or too small to get into (or close enough the loo to transfer).

You know those times when you just know you will be up and down to the loo all day – they are the worst days. I don’t know if I will be able to wait half an hour, an hour or three hours before having to dash home. You sure do feel those pot holes – in fact the number of potholes you bump over directly correlates with the urgency of need.

3. All public places have a disabled toilet, don’t they?

Where do I start with this one! Some don’t have any accessible toilets – going out usually involves using the internet or phoning places to ask for specific details. Often staff do not know what type of accessible toilet they have and provide the wrong information – or leaflets do not specify. Very annoying.

In England the law doesn’t say the public have to have access to a toilet – so councils are not obliged to provide them to anyone!! [Public Health Act 1936].  Generally though, there are good practice standards that should be incorporated into the design of buildings to include flushing toilet facilities that are accessible to disabled people.

The reality, however, is that not even my local or national hospitals meet these standards – never mind the pub down the road or the multi million pound cinema and bowling complex in town!

4. What types of toilets are there and what’s the problem with them?

Well, let us say someone has looked at the building regulations (known as Part M) and chosen to have an accessible toilet on site.  What could possibly go wrong!

Ignore regulations…

10155072_10201673897397303_1686122137207154089_nMy friend Carole found a great example from the New Inn in Durham – the door has no handle. The metal part is for a Radar Key. Some have a step up to them or  display the wheelchair symbol yet are not big enough for many modern day wheelchairs! Others use strong sprung hinges so you can’t open the door … the list goes on and on and the regulations might as well not exist.

Did you know there are 3 types of accessible toilets?

Yes – three! However – this doesn’t make them automatically comply with UK equality legislation or mean they are accessible to everyone.

Type 1 – Accessible to people who can walk.

The first is a slightly larger cubicle with some grab rails or a higher seat for example – these are for people with restricted mobility but who can walk a few steps – ambulant disabled people.

Some venues say they have a disabled toilet – but don’t say it’s only for those who can walk.  Some of these wrongly display the wheelchair symbol. This happened to me at work once and I had to cross my legs for 8 hours! The venue then went and built a new toilet block with two ‘wheelchair’ accessible toilets – but still these were not big enough for even a manual chair. Sometimes you just give up and I refused to go to that venue again. Not having toilets within reach can prevent disabled people from working – this is what happened to Boots Opticians when they failed to provide a nearby accessible toilet for a member of staff.

 

Type 2 – Accessible to some athletic wheelchair users who can perform acrobatics.

The second type displays the wheelchair symbol and is a toilet that should meet building regulations for wheelchair access.  The sticking point with these is that the recommended space is only big enough for the length of a compact /short length chair – and not everyone has one of those.

WC_dimensionsHere is a scaled picture of a wheelchair accessible toilet according to building regulations. The green rectangle is the footprint of my NHS power chair. Next to it is the recommended (same scale) turning area the regulations use for ‘enough space’. As you can see it’s based on a manual chair, it’s a tight fit and it doesn’t mean there is available floor space by the toilet where you actually need it!

 

Throw in the difficulty caused by the addition of a baby changing unit on the wall and baby nappy bin on the floor – no floor space or room at all to turn!

To deny someone appropriate toilet facilities is a huge black mark in the book of human dignity and rights.

 

My husband has to stand me up and then hold me to try and swing round and move me backwards between the gap of the sink and my chair, to sit on the loo! You have to be a circus performer to pull that one off without falling and banging into things. Not to mention trying to maneuver your clothes off …. that’s when you say ‘sod it’ and stay at home.

Type 3 – Accessible to all and includes an adult changing bench and hoist. They are known as Changing Places toilets.

These are few and far between – only 600 in the UK – if you need to change a pad without these facilities you might have to lay on the floor of a public toilet like this child has to do.

5. So what do you do then?

Stay at home, don’t visit family for long periods or spend lots of time finding out about the exact nature of the toilet facilities on offer – then decide whether to go or not.

Even more degrading for women.

Some men have the options of using a portable urine bottle – but women experience the most difficulty having to transfer to the loo every time and also deal with menstruation. Give yourself pins and needles so you can’t move your legs much, wear mittens and then try and change a pad or try asking your husband to help …. now try it in a cramped toilet on the first day of your period with the nauseating smell of baby poo lingering in the air. Not so nice is it?

Welcome to my world and hundreds of thousands of women like me – a part of our lives that goes unspoken about, unnoticed  – but it doesn’t have to be this way.

With proper facilities, assistance and good information, we can make informed choices and retain a level of dignity and hygiene that might otherwise be flushed down the pan.

Louise Watch, writing for Blogging Against Disablism Day 2014.  BADD2013

Blogging Against Disablism Day, May 1st 2014