All about support / grab rails

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Taken from our guide (see links page) we look at the importance of support rails in accessible toilets. AD M is approved document M of the U.K. Building Regulations.

It is possible to have many layouts to allow for the provided dimensions and fixture configurations in AD M.
 

The general layout of a unisex accessible toilet is to have horizontal grab rails to both the left and right side of the toilet [AD M: S 5.8].

Heights, lengths and distance from the toilet / sink / mirror etc must be precise as described in AD M.
Vertical rails must also be provided in specific places.

How many rails do people need?

74% of disabled/older people use handrails. They can be used to pull/push up with or simply to lean on for stability.

41% of powered wheelchair users prefer the right side, 30% the left and the rest had no preference in a 2005 study.

Some people need a rail both sides and on the back wall.  The rails needs to be the right height, length, distance from the toilet/sink, thickness and colour.

An accessible toilet must  have at least 5 support rails with additional ones if the toilet is located some distance from the wall. 


Barriers introduced

As can be seen above, support rails can infringe on the transfer space and cause problems for some wheelchair users.

Solutions

  1. Assess your toilet – do they have the full complement of support rails and are they in the right place and the right length / height? 
  2. Mix it up – the standard suggests that if you provide more than one unisex toilet, a choice of layouts for left and right hand transfer should be provided. 
  3. The smaller the space, the more grab rails will get in the way for powered wheelchair users and carers – re-consider your design space. 
  4. Provide Changing Places toilets in addition to existing accessible toilets. The larger spaces to the left and right of a central toilet offer more transfer option angles for people who use powered wheelchairs, large walkers/ frames, or need carers to assist them.

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. 

 

 

 

 

 

 

Guide 3 – Going beyond the minimum requirements

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Our third guide can be downloaded from: Links and resources page.

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Going beyond the minimum requirements

Our 26 page guide looks at why going beyond the standards is often required to avoid discrimination, promote social inclusion and welcome all disabled employees, visitors, customers and volunteers.

We hope you will find the information useful if you:

  • Are passionate about improving the accessibility and usefulness of toilets for disabled people through campaigns and personal discussions.
  • Wish to raise discussions with a business concerning a difficulty you have had accessing or using provided toilets.
  • Are designing or submitting planning applications involving a new accessible toilet or altering existing ones.
  • Are responsible for the maintenance of sanitation facilities.
  • Are planning an event or function and assessing the sanitary needs of potential visitors.
  • Are a business, who provides toilets for disabled staff, visitors, customers and volunteers – and wishes to provide the highest possible standard of ‘away from home’ toilets.
  • Are committed to the welcoming provision of a truly accessible toilet to demonstrate your commitment to social inclusion and equality.

 

Contents

Current types of accessible toilets
Legal requirements
Be aware of ‘Compliant Doc M toilet packs’
Difficulties people have using accessible toilets
How AD M introduces barriers to using the toilet 
Toilet height
Support / grab / hold rails
Barriers relating to support rails
Privacy
Space considerations 
Space is needed to do a range of activities in the toilet.
Space requirements in the Building Regulations. 
People who are unable to stand or balance on a toilet.
Barriers to using the toilet, in the minimum provided space.
What research tells us about the size of wheelchairs.
Inadequate space to transfer from the side of the toilet.
Space needs of Carers / Assistants.
Turning circle space inadequacy
Baby Changing and Odour sensitivity.
Emergency cords tied up or not present.
Ensuring the toilet is available.
Assistance with hygiene.
Thank you to: