Understanding what Changing Places toilets are and who they are for and where they should be located is just the beginning. The next crucial step is grasping the specific sanitaryware and accessories required and how they should be strategically positioned to cater to the needs of the intended users. By ensuring optimal placement of these elements, you will not only enhance accessibility, safety, and dignity for users but also support the responsibilities of caregivers.
Changing Places Toilets must include the following sanitaryware and accessories:
- Peninsular toilet with space both sides for assistants.
- Back rest on toilet seat.
- Grab rails and support rails.
- Adjustable height wash basin.
- Height adjustable, changing bench.
- Ceiling track hoist system.
- Privacy screen.
- Large waste disposal bin.
- Assistance alarm.
- Note: a shower is not required for all CP toilets.
Toilet Cubicle Doors
Changing Places toilet doors should open outwards, equipped with easy-action lever handle, ensuring a clear width of 1000mm for optimal accessibility. These doors should feature a horizontal rail on the inside at a height of 900mm. Additionally, consider incorporating automatic doors where possible to enhance convenience for both users and carers.
Toilet Cubicle Door Locks
Every Changing Places toilet must feature a privacy lock on the inside, designed to be easily operable for individuals with limited strength or manual dexterity. This could involve the use of large lever handles or sliders that can be operated with a closed fist. The lock should also include a red/white visual indicator, aligning with the specifications outlined in Approved Document M Building Regulations. Privacy locks should also contain a mechanism that will enable the door to be opened from the outside in case of an emergency.
Wheelchair Accessible WC
Toilets in the accessible Changing Places facility should be positioned at a height of 480mm and placed at least 1000mm from the nearest wall, to ensure easy transfer from a wheelchair or ceiling hoist, with ample space both sides for assistants. A back rest should be provided, with a shelf nearby to accommodate colostomy bags. It’s imperative that the toilet seat and fixings are robust enough to support someone during transfer and seating, avoiding seats with a gap at the front to prevent potential leg trapping.
Grab Rails and Drop-down Support Rails
In Changing Places toilets, provide wall-mounted vertical grab rails and drop-down support rails on both sides of the accessible WC for transfer assistance, with a visual contrast for easy identification.
Fixed grab rails require tubular design with 32-35mm diameter and minimum 600mm long. A 50-60mm clearance from the wall and the rail centre line set at 1100mm above floor level.
Height-adjustable, drop-down support rails are desired for greater flexibility and improved safety. When offering fixed height drop down support rails, the upper rail should be set at 680mm above floor level and placed 320mm on either side of the WCs centreline, projecting 50-100mm beyond the front when in a down position.
Wash Basin
Changing Places toilets deviate from Document M designs by positioning the wash basin not adjacent to the WC but for use after transfer. The wash basin should be wall hung, power-assisted and height-adjustable, ranging from 580mm to 1030mm above floor level to accommodate both standing and seated users, with adequate knee space. The basin should be fitted with a pressure-sensitive safety override to prevent potential leg trapping. If height-adjustable cannot be provided, install the wash basin at a wheelchair-accessible height (720-740mm from floor).
Taps
Within Changing Places toilets, opt for a centrally positioned manual mixer tap with a single long lever for user convenience. Alternatively, sensor taps can be installed, only if they are suitably responsive to prevent confusion among users. Ensure that water temperature is regulated, with hot water not exceeding 43 degrees Celsius for user safety.
Soap Dispenser
Soap dispensers in Changing Place toilets should be designed for easy one-handed operation and be mounted directly above the wash basin. They should be positioned within reach of a person seated in a wheelchair, with the underside between 800-1000mm above floor level. This ensures accessibility even when the basin is at its highest position.
Hand Drying
Hand drying facilities in Changing Places toilets should be conveniently located near the washbasin. Wall-mounted paper towels should be positioned 800-1000mm from floor level for accessibility and be easily operable with one hand. Additionally, a hot-air hand dryer should be provided on the door side of the washbasin, also at 800-1000mm from floor level. Both provisions must have clear visual contrast against their backgrounds to aid users with visual impairments. Avoid polished metal finishes as reflective surfaces are more difficult to see for individuals with visual impairments.
Changing Bench
A Changing Places toilet should include an adult-sized changing bench to accommodate individuals who cannot sit on the toilet or shower seat. The changing bench can be freestanding or wall mounted, measuring at least 1800mm long and 800mm wide, with an adjustable height range of 300-1000mm from the floor. Safety is paramount, so the bench should have a minimum safe working load of 200kg. Additionally, provide a dispenser with a wide paper roll (couch roll) adjacent to the bench for convenience.
Ceiling Track Hoist
A ceiling hoist spanning the entire Changing Places room, at a height of 2.4m, facilitates transfers between wheelchair, changing bench, WC, and wash basin. It should have a safe working load of 200kg, with the walls and ceiling structure capable of supporting this weight. Single track or mobile hoists are discouraged due to limited manoeuvring space and risk of removal. Clear instructions displayed prominently, and regular inspection, servicing, and maintenance of the hoist are essential to ensure its safe and effective use.
Privacy Screen
To preserve dignity, a curtain or screen should be installed between the accessible WC and the rest of the room. Wall mounted retractable screens or free-standing folding screens are recommended options.
Waste Bins
A sanitary disposal bin should be large enough to accommodate adult sized incontinence pads and be placed within in easy reach of the accessible WC. Additionally, a bin for general waste should be positioned for easy access whilst in the clear manoeuvring space.
Assistance Alarm
Two alarm pull cords should be within the Changing Places toilet: one adjacent to the toilet, reachable from the toilet itself, and another near the door which must be distinguishable from the light pull cord. The cord should be red with two red bangles, 50mm in diameter, one positioned 100mm from the floor and the other 800-1000mm. The alarm should be positioned where trained staff are permanently stationed to provide appropriate assistance when the alert sounds.
Shower
A shower is not required for all Changing Places toilets, as sometimes carers need a dry environment for changing individuals. Introducing a shower would require staff to dry the room immediately. If a shower is included within the facility, it is preferable to position it in the corner of the room to minimise spray across the rest of the area, enabling the facility to be used promptly by someone else.
Coat Hooks
Adequate coat hooks should be available to enable a Changing Places toilet user and two assistants to hang their coats and bags. Coat hooks should be positioned at two different heights: 1050mm and 1400mm from floor.
Mirror
A wall mounted mirror, 600mm wide and at least 1000mm tall, should be provided within a Changing Places toilet, positioned a minimum of 600mm above the floor. Additionally, a full-length mirror with unobstructed access should be provided to enable individuals to view themselves and adjust their clothing. It’s important to ensure that both mirror provisions do not extend to floor level, as this can create a false impression of being a door or wall opening.
In conclusion, understanding the intricacies of Changing Places toilets goes beyond recognising their purpose and target audience. It involves understanding the specific sanitaryware and accessories required and strategically positioning them to accommodate the diverse needs of users. Prioritising optimal placement not only enhances the washroom experience for the user but also provides invaluable support to caregivers. Designing inclusive and accessible washrooms ensure that every individual is catered to and offered a dignified approach to this essential necessity.