Access all areas

Mark Sadler of Closomat highlights why it’s vital to adopt accessible bathroom features in rented properties and reveals any hidden costs and product considerations involved in the process

Bathroom adaptations are driving a growing debate about how to balance the provision of any necessary and appropriate adjustments against the housing provider’s considerations of what is reasonable and practical. The balancing act is only going to continue.

In the UK, statistics show that people with disabilities are twice as likely to be in social housing than non-disabled people. In addition, one in five people in the UK are registered disabled, while our population is ageing rapidly. By 2025, over 20 per cent of those living in the UK will be aged 65 or over.

By that same time, it is predicted that almost one and a half million people aged 75 or over will be unable to manage at least one mobility/daily living activity independently – including using the toilet on their own.

At the other end of the age spectrum, the number of disabled children is also on the rise – by more than 60 per cent in the last 25 years. All this means a potentially significant number of tenants would require some kind of home adaptation – now, or in the near future.

However, according to the ‘Better Outcomes, Lower Costs’ report, carried out by the University of Bristol on behalf of the Office for Disability Issues at the Department for Work and Pensions, there should be little doubt about what landlords should opt for. The report reads: “If, for the same money, a disabled person may have a carer come every day in to lift them on and off a commode and help them to wash, or may choose an automatic toilet and level access shower to use whenever they please, they will normally choose the solution that offers more dignity and autonomy.”

Hidden cost

Bathrooms are the spaces that most commonly require adaptations, but there is a hidden cost, which needs to be borne in mind when planning to undertake an adaptation. The rise of single occupancy households is placing a strain on care services, and solutions, which require carer assistance, instantly carry a higher cost consideration: the provision of a paid care worker to assist the resident, irrespective of the capital cost of the living aid.

An often-overlooked factor in assistive technology specification is that we all change with time, and what solves a situation now could quickly become redundant, requiring further alterations, disruption and cost. That’s why any adaptation needs to be judged not on the initial capital cost, but the long-term best value, taking into account its lifespan, and whether an additional pair of hands is required.

Beyond adding value to a property, adaptations can help residents retain their independence in the home, which can in turn enhance their wellbeing. In addition, research shows that an adaptation pays for itself within a year, and landlords in England, Northern Ireland and Wales can further cut their refurbishment costs by applying for a state-funded Disabled Facilities Grant.

Addressing mobility issues

There are a number of solutions for housing providers looking to carry out a stylish adaptation of an existing bathroom, or to create a brand new accessible bathroom.

A cost-effective option for the whole space can be the incorporation of a rail-based system, whereby a track is installed around the wall, onto which a raft of aids – from support arms to washbasins and shower seats – can be added, moved, or removed, as required.

In toileting specifically, there are two main considerations regarding a person’s mobility: whether they can get on and off the toilet, and if they are able to clean themselves properly. Solutions depend on the length of time the occupier would require assistance and what their long-term prognosis is.

Getting on and off may initially be addressed by the provision of a grab rail, or support arms, but those assume the user has the manual dexterity to grip and the strength to weight bear. Another solution is a toilet lifter, which is the WC equivalent of a riser recliner chair, and can be easily fitted over the pan as it requires no structural support or plumbing – just an electrical connection.

Which solution is chosen depends on the user’s specific issues: most offer a tilting action as they raise, hence the analogy with a riser recliner chair. However, people who typically require such equipment often have balance problems and prefer a vertical lift option that still lifts them up, while the seat remains horizontal.

Common solutions

One of the most common toilet adaptations is the removal of a conventional toilet and its replacement with a wash & dry (automatic bidet) toilet, particularly if the user has a long-term requirement. Options range from basic models that clip onto conventional toilet seats, through to toilets with integrated douching and drying, complete with a remote control.

The choice is influenced by the length of time the equipment will be needed, and the recipient’s mobility and agility now and in the foreseeable future. Anecdotal evidence indicates the bolt-on options are the most cost-effective short-term solutions: fixings and brackets tend not to be robust enough to withstand long-term stress from transfer, nor bariatric usage. Equally, remote-controlled units require the user to be dextrous enough not to drop the controller and to be able to operate the buttons.

More information on the types of solutions and their application can be found as part of a White Paper on effective design and execution of an accessible toilet in a domestic environment.

Adapting to change

Since no two people are the same, nor do they have the same issues, aids that offer the flexibility to be adapted or accessorised would provide a better long-term value.

Accessories can be fitted either at initial installation or retrofitted without major disruption as and when the user’s needs change. Thus, for example, at outset if the user is able to operate conventional flush pads, but later becomes frailer and lacks the manual strength to do so, a touch-sensitive switch or an infra-red switch can be added. Likewise, a child may need a support system fitted initially, but that can be altered or removed in the future.

Such additions can help deliver better value, extending the relevance of the equipment even when a user’s needs change, and ensure your tenants are appropriately accommodated without straining your budget.

Mark Sadler is the sales director at Closomat