Bathrooms & Changing Places

The step over the edge of a shower tray or into a bath is, for a huge number of people, the moment bathing becomes dangerous or impossible. Remove that step and you have taken the single most valuable decision in an accessible bathroom. The level-access shower - a curbless shower where the floor of the room and the floor of the shower are one continuous, gently falling surface - lets a person walk, roll a shower chair, or be wheeled straight in with nothing to climb over. It is the wet-room principle: the whole room, or a generous zone of it, is tanked (fully waterproofed) and laid to a slight fall toward a drain, so water goes where it should without a lip to contain it.

Getting this right is a construction detail, not just a layout choice, and it is where level-access showers most often fail. The floor must fall enough to drain - a gentle, walkable gradient toward a linear channel or a well-placed gully - without becoming a slope that tips a shower chair. The waterproofing has to be continuous and detailed properly at the junctions, because a level threshold that leaks is a callback and a rot problem. Choose a slip-resistant floor finish rated for wet, barefoot use; a beautiful polished tile that is lethal underfoot when wet has failed at its one job. A half-height glazed screen or a shower curtain on a curved track can keep the worst of the spray off the rest of the room while still letting a carer reach in and a chair roll through.

The payoff is enormous and quiet. A level-access shower serves the wheelchair user and also the pregnant woman, the person recovering from a knee operation, the older couple who want to stay in their own home, and the parent hosing down a muddy child. It reads as clean and contemporary, not medical. As with every figure in this course, confirm the exact fall, drainage and slip-resistance requirements against your local standard - but the principle, level access with proper drainage and a safe finish, holds everywhere.

A level floor gets a person in; the fittings let them wash safely. The heart of an accessible shower is somewhere to sit: a fold-down shower seat fixed to solid backing, or space for a mobile shower chair. Many people cannot stand for the length of a shower, and washing while seated is safer for almost everyone. Beside and in front of the seat, provide grab rails - typically a vertical rail to pull up on and a horizontal or angled rail to steady with - all fixed to blocking or a solid substrate, never to tile over plasterboard, and set in a tone that contrasts with the wall so they can be found by touch and sight.

The controls matter more than they look. Use a thermostatic mixing valve so the water cannot suddenly run scalding when someone flushes elsewhere - anti-scald protection is a genuine safety requirement, not a luxury, especially for people with reduced sensation who may not feel a burn beginning. Place the control within reach of the seat, so a person does not have to stand or lunge into the cold stream to turn it on, and choose a large lever rather than a fiddly knob. A shower head on a sliding rail lets it be used seated or standing and by people of different heights. Keep soap, shampoo and a towel within the seated reach range; a niche at the right height beats a caddy hung out of reach.

Drainage and the wider bathroom complete the picture. A linear drain along one edge often manages water more predictably than a single central gully and allows a cleaner single-direction fall. In the room beyond the shower, apply the same logic you learned for the WC: a clear transfer zone beside the pan, a turning space of roughly 1500 mm, a basin reachable seated, lever taps, and a mirror usable sitting or standing. Where a bath is wanted, provide transfer space alongside it and consider a bath lift or a built-in transfer seat - but recognise that for many disabled and older people a level-access shower is simply safer and more independent than any bath. Confirm the binding dimensions and the anti-scald temperature limits against your current code.

Now to the room that everyday accessible bathrooms cannot replace. A Changing Places facility is a large, purpose-designed room for people who cannot use a standard accessible toilet independently - people with profound and multiple learning disabilities, advanced multiple sclerosis or motor neurone disease, and others who need to be changed lying down and moved by hoist. The standard accessible WC assumes a person can transfer onto a seat; a great many people cannot, and for them a normal accessible toilet is no more usable than a flight of stairs.

A Changing Places room provides what those people actually need. There is an adult-sized, height-adjustable changing bench - a child's nappy-changing table is not enough and lying on a toilet floor is a daily indignity that people are forced into for want of this one fitting. There is a ceiling-mounted hoist, usually running on a track, so a person can be moved between wheelchair, bench and WC without a dangerous manual lift that risks both them and their carer. There is a peninsula (centrally placed) WC with space on both sides so a carer can assist from either hand. And there is simply space - room enough for the disabled person, one or two carers, a wheelchair and the equipment to move around each other. A commonly cited planning figure is on the order of 12 square metres of clear floor with adequate ceiling structure for the hoist, but confirm the required area, layout and equipment against the current specification and your local code.

Where do these belong? In the buildings where people spend a day or gather in numbers: large transport hubs, stadiums and arenas, shopping centres, hospitals, city-centre cultural buildings and major public attractions. The test is simple and humane - if you expect people to be in your building for hours, you must provide somewhere they can be changed with dignity, or you are quietly telling a whole group of citizens to stay home. The plan opposite shows the essential kit: the bench, the hoist track, the peninsula WC and the clear space around them.

Not every bathroom needs to be a Changing Places room or a full wet room on day one, but almost every bathroom benefits from being designed so it can become more accessible without demolition. This is the adaptability principle, and it costs very little at construction and saves a great deal later. The cheapest, most valuable move is to install solid backing (blocking) in the walls around the WC, shower and bath during construction, wherever a grab rail might one day go. Rails can then be added in an afternoon, screwed into timber or ply that is already there, instead of opening up finished tiled walls to find something to fix to.

Other future-proofing moves are equally quiet. Run the drainage and fall so a shower tray could later become a level-access shower without re-laying the whole floor. Leave the room a little more generous than the minimum so a turning space and a transfer zone can be found when needed. Specify a thermostatic valve and lever taps from the start, since they help everyone anyway. Choose flooring that is slip-resistant now, not something you will regret when a resident ages. Think about door swings: a door that opens outward or slides will not trap a person who has fallen against it, and costs nothing extra to hang that way.

This is what 'designing for a lifetime' means in practice - not that every home has a hospital bathroom, but that the bathroom you build for a young family will still serve them after an injury, a pregnancy, or forty years of ageing, and can be upgraded step by step as needs change. It is the same spine that runs through this whole course: build inclusion in early, when it is nearly free, rather than bolting it on late, when it is disruptive and expensive. A bathroom is one of the most costly rooms to rebuild and one of the most dangerous to get wrong, which makes it exactly the room where a little foresight pays back most. Verify the specific provisions - backing, drainage, valve limits, clearances - against your local standard as you specify.