Traditional accessible toilets do not often meet the needs of the thousands of people with profound and multiple learning disabilities as well as other severe impairments such as spinal injuries, muscular dystrophy and cerebal palsy.
A Changing Places toilet has more space and provides the equipment people need to be able to use the toilet in safety and comfort. It is important that these features are all present in order to make sure the toilet is suitable for those who need it most.
Each toilet must provide an adult sized, height adjustable changing bench, a hoist and a peninsular (centrally placed) toilet.
Read below to find out more about equipment needed in Changing Places toilet:
An adult-sized changing bench is an essential part of a Changing Places toilet.
A changing bench provides a comfortable, stable platform to get changed on for people who use incontinence pads or who need help undressing to use the toilet. They can also be used for showering.
Height adjustable models enable the bench level to be lowered to a suitable height for self-transfer from a wheelchair or assisted transfer using a hoist, and then raised to a working height for one or more assistants.
A hoist is an essential part of a Changing Places toilet.
It eliminates the need to lift a person manually, thus reducing the strain on carers' backs and therisk of injury to the person being transferred. It aids access to the changing bench, so carers no longer have to use the toilet floor for changing.
A hoist reduces the need for extra help and allows someone who cannot self-transfer to move about the room with comfort and dignity.
Hoists are available in a variety of types to meet different needs and can be custom made to fit specific spaces.
In a Changing Places facility, the toilet should be sticking out like a "peninsular" at least a metre away from the walls on either side. This means there is space on both sides of the toilet, allowing wheelchair transfers or assistance from carers.
The actual toilet itself can be a standard manual toilet. An automatic wash-and-dry toilet may be provided, but is not a requirement of the Changing Places standard. Close-coupled toilets are a good choice as this design provided an integral backrest and, as long, as the cistern has a flat top, provides a shelf for colostomy bags. The toilet in the illustration (left) is not a close-coupled toilet but has been installed with an additional backrest.
The toilet should have a seat height of 480mm, to facilitate transfer from a wheelchair. Seats with a gap at the front should not be used as this shape can make it difficult for people to transfer and the gap is a potential hazard.
Wall-mounted vertical grabrails and drop-down support rails should be provided to both sides of the toilet to offer support to people when transferring in a seated position. The wall-mounted vertical grabrails assist people adopting a frontal transfer and people who are able to stand while using the toilet.
Both wall-mounted vertical grab rails and drop-down support rails should be fixed to the wall either side of a peninsular toilet to offer support to people while transferring and while seated.
Drop-down raisl can be lowered to assist during transfer or to provide support to a person while seated on the toilet. They should be raised back against the wall when not in use, so they do not obstruct transfer using a hoist.
It is essential that grab rails, support-rail fixings and the structure on which they are fitted are strong enough to support the weight of a person.
A washbasin needs to be provided in a Changing Places toilet. The washbasin should have clear knee space below the bowl, to allow a wheelchair user to comfortably use it.
It is recommended that the basin is intalled 720-40mm above the floor.
A fixed washbasin can be installed in a Changing Places, but we do recommend a height adjustable model is provided.