There are a number of reasons why someone may need to use an accessible toilet or changing facility and it is important to recognise that legislation supports access for all and not just those with a perceived disability. Legislation and good practice documents are in place to support accessibility across the spectrum of need.
Building Regulations Approved Document M
Building Regulations Approved Document M (buildings other than dwellings) 2015.
Part 2 of Doc M outlines the statutory guidance for the access to and use of buildings other than dwellings.
In principle suitable sanitary accommodation should be available to everybody, including wheelchair users, ambulant people with another form of disability, people with babies or people carrying luggage.
Sanitary accommodation needs to address issues for people with visual or hearing impairments, people with learning difficulties, people with limited dexterity and people whose lack of tactile sensitivity can cause them to be injured by touching hot surfaces for example.
Toilet accommodation needs to be suitable not only for people with a disability but for all people who use a building or public space.
Unisex wheelchair-accessible toileting facility
For wheelchair users, a self-contained unisex toilet is the preferred option, as it allows a partner or carer of either sex to give assistance.
Wheelchair-accessible unisex toilets should always be provided in addition to separate gender accessible facilities. Even if space for only one toilet in a building, it should be of wheelchair accessible unisex type.
Wheelchair users should be able to approach, transfer to and use the toilet facilities and should not have to travel more than 40m to reach a suitable toilet.
In large building complexes, there should be one wheelchair-accessible unisex toilet capable of including an adult changing bench. There should also be an enlarged toilet cubicle for people who need extra space, and considerations should be given to installing a fold-down changing table.
Any wheelchair-accessible washroom should have at least one lower washbasin with the rim set at 720-740mm, one urinal with a rim no higher than 380mm and grab rails. The toilet should be able to accept a variable height toilet seat riser.
Example of a unisex wheelchair-accessible toilet with corner WC facility
Changing Places/sleeping accommodation
If shower facilities include a toilet, ideally a choice of left and right transfer layouts should be provided; if just one is provided, it should be right-hand transfer.
Under Document M, it is ‘desirable’ to include a Changing Places toilet in addition to a conventional wheelchair-accessible toilet, in any building where numbers of the public have access or spend periods of time. See section on BS8300-2:2018 for further guidance.
A unisex accessible toilet (minimum 2.2m x 1.5m) should be located as close as possible to the entrance and/or waiting area of a building. Unisex accessible toilet accommodation should be provided near to bedrooms designed for wheelchair users if the general sanitary arrangement for standard bedrooms in a hotel is not en-suite.
Wheelchair-accessible bedrooms should give the wheelchair user the ability to access and conveniently use toileting facilities. En-suite sanitary facilities are the preferred option for wheelchair-accessible bedrooms. Wheelchair users should be able to access other bedrooms, to visit family for example.
There should be at least one wheelchair-accessible bedroom for every 20 bedrooms. There should also be available a bathroom AND shower room for independent use, incorporating an accessible toilet.
BS8300-2: 2018 Design of an accessible and inclusive built environment.
This good practice guidance applies to buildings that require bathing facilities, such as hotels, motels, nursing or residential homes, hostels and halls of residence.
There should be an en-suite with corner toilet for independent use: ideally both left – and right-hand transfer options are provided; if only one is included, it should preferably be right-hand transfer.
Where space is limited – for example, in small business premises, the provision of a single accessible toilet compartment of unisex design instead of separate-sex facilities caters for all needs with less demand on space.
Accessible bedrooms should always be provided with en-suite toileting facilities if the general sanitary arrangement in the multi-occupancy building adopts an en-suite approach for any other standard bedrooms. This includes all building types that require permanent sleeping accommodation for disabled people, including hotels, motels, nursing, residential and care homes, university and college halls of residence.
Ceiling track hoist system
A ceiling track hoist system, for transfers between a wheelchair, bed, chair, shower or bath and toilet, can provide the required support to assist a person to move between different locations and potentially reduce transfers.
En-suite facilities should be the preferred solution where there is no such approach, as disabled people might have difficulty moving from one room to another.
If such a solution is not possible, the sanitary facility and the bedroom should provide separately the same degree of accessibility and be located close to one another.
It can be advantageous for some accessible bedrooms to have a connecting door to an adjoining room for use by an assistant or family member.
The standard lays out specific recommendations for hotels and student accommodation.
Example of an en-suite facility shower room with ceiling track hoist
Accessible bedrooms should always be provided with en-suite accessible sanitary facilities, including a toilet, basin and shower (or bath) if en-suite facilities are provided for any other bedrooms.
The minimum provision of accessible bedrooms as a percentage of the total number of bedrooms should be:
- One room or 5%, whichever is the greater, with a wheelchair-accessible en-suite shower room for independent use.
- A further one room or 1%, whichever is the greater, with a tracked hoist system and a connecting door to an adjoining (standard) bedroom for use by a carer.
- One room or 5%, whichever is the greater, with an en-suite shower room to meet the requirements of people with ambulant mobility impairments.
A further number of bedrooms to make up a total provision of 15% of all bedrooms should be large enough for easy adaptation to accessible bedroom standards (with en-suite facilities) if required in future and be structurally capable of having grab rails installed quickly and easily.
In student accommodation, the minimum provision of accessible bedrooms as a percentage of the total number of bedrooms should be:
- One room or 4%, whichever is the greater, that are wheelchair accessible.
- One room or 1%, whichever is the greater, with a tracked hoist system, and a connecting door to an adjoining (standard) bedroom for use by a carer (see figure above).
- 5% easily adaptable wheelchair accessible rooms for independent use.
A ceiling track hoist system that covers the entire room, gives the greatest flexibility of use.
It makes the best use of the available space and improves a person’s privacy and independence by allowing transfers to be made within the shower/bathroom/en-suite, if required.
BS8300-2-2018 states that Changing Places Facilities should be provided IN ADDITION TO a conventional wheelchair-accessible toilet.
They should be a standard inclusion in all publicly accessible buildings, for example, arenas, motorway services, hospitals and transport hubs.
A Changing Places toilet room provides a minimum 3m x 4m, to accommodate the wheelchair user and up to two carers, plus additional fixtures including an overhead track hoist, adult-sized changing bench and privacy screen.
Changing Places facility
Example of fittings and accessories in a Changing Places facility.
Space to Change
Whilst not a best practice or legislative requirement, campaigners have developed the concept of Space to Change, for buildings where there is not the space in communal areas to accommodate a full-specification Changing Places room. It provides guidance where space is limited, for example in small buildings and refurbishments.
Space to Change builds on the Building Regulations Document M provision of at least a 3m x 2.5m wheelchair accessible unisex toilet. It adds to that Standard an extra 7.5m of space, to accommodate a hoist and adult-sized changing bench.
There should be available a bathroom AND shower room for independent use, incorporating a toilet.
Space to Change facility
Example of fittings and accessories in a Space to Change facility.
Equality Act 2010
The Equality Act 2010 replaces the Disability Discrimination Act.
Under this legislation, service providers have a duty to make reasonable changes – including to the built environment – where a disabled customer or potential customer would otherwise be at a substantial disadvantage; previously, such changes were only required if it would have been impossible or unreasonably difficult for the person to access or use the service.
The Equality Act 2010 requires that service providers must think ahead and take steps to address barriers that impede disabled people, making appropriate adjustments.
The statistics demonstrate potential positive impact of having accessible facilities can have on the community:
- On average a person visits the toilet 8 times each day.
- One in five of the population in England and Wales – have a form of disability that impacts on their daily life (ONS 2015).
- The number of students with a disability in higher education has risen to 16.2%. This is an increase of 36% since 2014/15 (Hubble and Bolton, 2020).
- 1 in 10 people is affected by bowel incontinence at one time in their life (RCN, 2020).
- Over 35 million people in the UK are overweight or plus sized (Cancer Research UK, 2019), which makes reaching parts of their body difficult for toilet hygiene and can cause an increase in urinary frequency (through diabetes).
- There are over 1.2 million wheelchair users in the UK (NHS England, 2021).
- Groups that include a person with a disability spend £15.3 billion per annum on tourism and travel in the UK. (Visit Britain, 2018).
This does not even take into consideration the millions of parents/guardians with pushchairs, people with sensory needs and many other groups who require accessible spaces.
Age UK (2019) Care Homes (England), retrieved from: https://www.ageuk.org.uk/globalassets/age-uk/documents/policy-positions/care-and-support/ppp_care_homes.pdf (accessed on 24/01/2021).
Cancer Research UK (2019) Overweight and Obesity Statistics, retrieved from: https://www.cancerresearchuk.org/health-professional/cancer-statistics/risk/overweight-and-obesity#heading-One (accessed on 23/01/2021).
Hubble, S. & Bolton, P. (2020) Support for disabled students in higher education in England, retrieved from: https://commonslibrary.parliament.uk/research-briefings/cbp-8716/ (accessed on 21/01/2021).
Leung FW & Schnelle JF (2008) Urinary and Fecal Incontinence in Nursing Home Residents. Gastroenterol Clin North Am. Sep; 37(3):697-707
Office for National Statistics (2015), retrieved from: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/disability/articles/ nearlyoneinfivepeoplehadsomeformofdisabilityinenglandandwales/2015-07-13 (accessed on 23/01/2021).
NHS England (2021) Improving Wheelchair Services, retrieved from: Royal College of Nursing (2020) Types on incontinence, retrieved from: Office for National Statistics (2015), retrieved from: https://www.england.nhs.uk/wheelchair-services/ (accessed on 24/01/2021).
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/disability/articles/ nearlyoneinfivepeoplehadsomeformofdisabilityinenglandandwales/2015-07-13 (accessed on 23/01/2021).
Visit Britain (2018) The Value of the Purple Pound, retrieved from: https://www.visitbritain.org/business-advice/value-purple-pound (accessed on 24/01/2021).