Adequate sanitary facilities in convenient locations are an essential part of the built environment.
See also: Fixtures and fittings
Provision and location
Suitable sanitary facilities should be provided in convenient locations to meet the needs of all building users.
The range, location and type of facilities that are required will depend upon the type and size of the building and its occupancy levels.
The provision of sanitary facilities is dependent upon the number of building users, whether access to toilets is restricted to certain periods such as during theatre intervals, and travel distance from where users are expected to be located.
Travel distances to accessible toilets should not be significantly greater than that to standard facilities.
Building users arriving at a location often need to use the toilet and the provision of suitable facilities near the arrival point will be appreciated. This is particularly the case in transport buildings where on board toilets may not be suitable.
Separate facilities should be provided for customers wherever possible. Staff facilities should be accessible and usable by all employees.
The location of alternative or additional facilities should be clearly identified. This is particularly relevant, for example, where alternate handed (mirrored) accessible toilets are available in another part of the building.
Where trained assistance is available (e.g. sports centres, swimming pools or where users are accompanied) additional toilets can be included that have been designed for people who need assistance.
In retail or leisure complexes, the provision of family toilets will allow adults to maintain close supervision of children.
Temporary provision of sanitary accommodation (for instance at periodic outdoor events or music concerts) should be as accessible as permanent facilities.
Wherever possible larger sized cubicles should be provided, especially where there is excess space in the facility circulation areas.
Single sex toilets
As the population increases in stature, conventional sized cubicles have become too cramped. Large commercial toilet roll dispensers further reduce the space available. In some circumstances, building users are carrying luggage or shopping, or are accompanied by children. Larger cubicles will be appreciated by those who need more space.
At least one cubicle should be fitted with grab rails for people who may need the support. In the event that the user falls on the floor, the cubicle could have the door opening outwards. However, this creates a possible hazard for people who are blind or have low vision when it is left open. Therefore, this toilet should have the ability to lift off the toilet door to gain emergency access.
Most people (both men and women) entering toilet facilities look for the urinals to identify whether or not they are in the correct gender toilet. Confirmatory accessible (tactile as well as visual) signage just inside the main entrance to the specific facility would give them this information without possible embarrassment. Pictograms alone should not be relied on to inform the user.
Gender neutral toilets
Gender neutral toilets with a washbasin can be extremely useful. They are available to everyone and if larger than standard compartments are provided they can accommodate families and those with luggage. If vertical rails are provided, they will also be appreciated by people with ambulant disabilities.
Unisex accessible toilets allow a person to be accompanied by a carer of the opposite sex and they are also gender neutral. Unisex facilities are therefore ideally suited to public buildings and should be located next to single sex facilities.
Accessible facilities in single sex areas (in addition to unisex) provide choice and flexibility.
Some wheelchair users prefer to transfer from their chair to a toilet to the right, some to the left. In order to cater for all preferences, alternate accessible toilets should be handed (mirrored) and signage should indicate the location of the other option.
In existing accessible toilets the biggest management issue is the use of the space as a baby change area. The installation of a baby change table together with large bins may significantly reduce the circulation and transfer space a wheelchair user might need. If baby change facilities and accessible toilets are to be in the same space, a larger than standard compartment is required. This will allow the baby change table (when hinged upwards) and waste bins (with a permanent position) to be well clear of the transfer space.
Combined use may be proposed where only one toilet is provided in a building. However, this will compromise the opportunity a wheelchair user has to go to the toilet. Where more toilets are provided in a building, a separate baby change room should be provided.
Standard accessible toilets are not usable by people with high needs who often have to be laid flat by carers to effect a change. In the absence of suitable facilities this could mean someone being laid down on the floor of the toilet which is undignified, unhygienic and unsafe.
A changing places bathroom does not replace an accessible toilet but is installed in addition. A changing places bathroom includes:
- an adjustable-height changing bench and wide tear-off paper roll to cover the bench
- a ceiling track hoist for a person to transfer between a wheelchair and either the WC or changing bench
- a peninsular-arrangement WC with privacy screen or curtain
- large waste bin for pads and continence aids.
If a ceiling track hoist cannot be installed, a mobile hoist should be provided.
- Provide an accessible toilet near to the arrival point in buildings.
- Ensure the location and arrangement of male, female and unisex accessible facilities is the same on different floors of the same building.
- Ensure toilets for customers and staff are separate wherever possible.
- Where only one toilet is provided within a building ensure it is a unisex accessible toilet suitable for use by everyone.
- Provide gender neutral toilets with a larger cubicle, wash basin and vertical grab rails.
- Ensure adequate provision of accessible toilets and cubicles in single sex toilets taking into account the numbers and likely ratios of male to female, the time taken for use and any restrictions on availability (for instance, during theatre intervals).
- Where space allows, enlarge standard facilities to include provisions designed for both standing and seated users.
- In single sex toilet accommodation provide an enlarged cubicle for people who need extra space and one designed for people with mobility difficulties.
- Where appropriate provide family toilets where a small group can be accommodated in a larger facility.
- Provide signage (both outside and inside the room and using words, tactile pictogram and tactile information) to indicate the purpose and gender of the facility and directions to alternatives.
Building Code requirement
Building Code clause G1 Personal hygiene:
G1.3.1 Sanitary fixtures shall be provided in sufficient number and be appropriate for the people who are intended to use them.
G1.3.3 Facilities for personal hygiene shall be provided in convenient locations.
G1.3.4 Personal hygiene facilities provided for people with disabilities shall be accessible.
Unisex accessible toilets should be easy to access and use.
- Ensure single sex accessible toilets have the same facilities as a unisex accessible toilet.
Opening a door against the pressure of a door closer can be difficult. For people in wheelchairs, this can make a facility unusable. Where toilet doors need to be closed for visual reasons the use of rising butt hinges or very low force door closers should be considered.
Outward opening doors provide more space within the cubicle and can still be opened if the user falls on the floor against the door. However, they can swing into circulation space if the area is not protected by projecting walls.
Inward opening doors (unless retractable stops are fitted) cannot be opened outwards. Consequently, a user falling against the door will pose a problem to anyone trying to help.
Some wheelchair users find the sideways push/pull action of a cavity slider door more difficult, some easier than opening a swing door. Wheelchair users with power chairs and people with mobility aids prefer sliding doors as they do not have to manoeuvre around a swing door. Swing doors cannot be pulled towards you with a clenched fist.
Door clear opening widths and turning circles need to take into account that wheelchairs are not all of a standard size with power wheelchairs being larger than manual wheelchairs.
Once inside the toilet, the door needs to be closed and locked and this will mean sufficient space to turn around.
Many wheelchair users may not have the dexterity to use their fingers. Consequently, door locks will need to be operated with a clenched fist. In case of emergency, door locks should be capable of being opened from the outside.
- Locate accessible toilets where fire or smoke considerations do not require the door to be fitted with a door closer.
- If required for visibility purposes, install a low pressure door closer or rising butt hinges.
- For an outward opening door, fit a horizontal rail on the inside to assist in closing the door.
- Where an inward opening door is proposed, enlarge the cubicle to allow suitable clear turning space inside Fit an emergency release mechanism to allow the door to be opened outwards should the need arise.
- Where a cavity slider door is used fit projecting vertical pull handles to both sides of the door but ensure clear opening widths are achieved. If not top hung, the tracks should be recessed into the floor.
- Ensure clear opening widths for toilet doors suit the sizes of anticipated wheelchairs and take account of the need to turn from corridors.
- Ensure door locks can be operable with a clenched fist (e.g. by a lever). These locks should have the capability of being opened from the outside in the event of an emergency.
Once the door is locked, the wheelchair user will position their chair for transfer to the toilet seat. Some will transfer head on where they will stand, hold the vertical rail, turn round and then sit down. Some will need to transfer from an oblique position whilst others will need to back up against the rear wall and transfer from the side.
In corner accessible toilet facilities, the pan can be on the right or left hand side of the wheelchair depending upon the design. Some users prefer to transfer to the right and others to the left. Therefore where more than one accessible toilet is installed, layouts should alternate left and right (ie. handed or mirrored) to provide the greatest opportunity for users.
Some wheelchair users may need space between the pan and the wall for a helper. However, if this is too big it may affect the use of the grab rails for those with limited reach.
If anything is positioned or installed in the transfer space by the side of the toilet (for instance, hand dryers, bins, baby change tables) lateral transfer will probably be prevented from taking place. This is a particular problem when additional equipment is installed in minimum sized enclosures.
- Ensure the footprint of the toilet allows a wheelchair user to turn round in the space clear of the door swing.
- Ensure the transfer space at the side of the toilet is clear to allow the wheelchair to be backed up against the rear wall.
- Ensure the toilet enclosure is made bigger if a baby change facility is to be co-located.
If the toilet seat is not at the right height, transfer to and from the wheelchair can be difficult.
The toilet pan and seat needs to be robust and secure. Wheelchair users generally have limited or no strength in their lower body. Therefore, the move from chair to seat is usually facilitated just by hands and arms. If the toilet pan and seat are not structurally adequate, it is likely wheelchair users can fall and be hurt and that fittings will be damaged.
- Ensure the toilet pan projects sufficiently from the rear wall to allow the seat of the wheelchair to be adjacent to the toilet seat.
- Ensure the toilet seat is at a height to match the average wheelchair seat height.
- Ensure the cistern and toilet seat are secure as they may be used for support when moving between the chair and the toilet seat. The seat must have metal fixings and preferably stabilising buffers which prevent the seat from moving sideward.
When the physical transfer is complete, the wheelchair user is sitting on the seat but may be fully clothed (If they are clothed they will need to move from side to side and rock back to front to release their affected clothes using the cistern or back support and the horizontal side rail.
The back support is also important for people with reduced upper strength and balance who need to be supported in the relevant upright position to facilitate muscle contraction and voidance.
Once clothes have been adjusted the user will use the toilet. During this stage they may need to steady themselves and this is one function of the horizontal rail on the side wall.
- Provide a back support. If this is not installed, the lid of the cistern needs to be securely fitted and not able to be easily detached. Any seat cover fitted should be flat and not have a rim which may dig into the user's back.
- Where mid-level or high-level cisterns are used, or where cisterns are concealed, ensure a back support is provided.
- Ensure all grab rails and other fittings that might be used by someone as a support are attached to structural framing.
- Position a rail at the side of the toilet to provide support when using the toilet standing up or during a frontal transfer to the seat.
Toilet roll dispenser
If a commercial sized toilet roll holder is installed too close to the rail, it may prevent the handrail from being grasped. The dispenser may also prevent sideward movement of shoulders when users are adjusting clothes or cleaning themselves.
- Position a standard toilet roll holder below the horizontal rail.
- If a large commercial type toilet roll dispenser is proposed, ensure it does not interfere with the use of the grab rail or restrict wheelchair user’s movements. Consider recessing it into the side wall.
Some users may need to wash and dry their hands before readjusting their clothes or transferring back into their wheelchair.
Some wheelchair users may prefer to transfer back into their seat and wash their hands facing the wash hand basin. It is important they can approach the basin easily.
- Ensure the handbasin and its controls can be reached from the toilet pan and easily used.
The position of the floor drain in an accessible toilet and shower is important. Wheelchairs need a level surface to manoeuvre and drains require a sloping floor to be efficient.
- Avoid the siting of floor wastes near where a wheelchair might manoeuvre to prevent the de-stabilising effect of changes in the slope of the floor.
Paper towel dispensers
Paper towel are preferred by many as being more hygienic and also able to be used to open the door without touching it. However, they can be over filled and some slim line designs make touching the dispenser much more likely.
The dispenser should be in a position where it is easily reachable by someone in a wheelchair or standing up.
- Ensure the design allows towels to be removed easily without touching the casing.
- Provide paper towels even when a hand dryer is installed.
Manually activated hand dryers may be preferable to proximity hand dryers as these may be activated when the wheelchair user is moving around the facility. However, manual operation may mean touching the casing.
If proximity activated hand dryers are installed, ensure they only operate when the hands are close to the unit to prevent them working when not needed.
If paper towels are not provided, the hand dryer needs to be within reach of someone sitting in a wheelchair or standing.
- Where an automatic hand dryer is installed, ensure it is not activated until the hands are close to it.
- Ensure the installation of the hand dryer does not interfere with manoeuvring space.
Once toileting is complete, the wheelchair user will transfer back into their chair. At this point they will need to flush the toilet. With restricted reach and limited dexterity they will not be able to use conventional flush mechanisms and may have to operate the flush with their elbow or wrist. A lever action flush situated on the transfer side of the cistern is a good option.
Flushes operated by hand movement near a sensor can be helpful but need to be positioned in the right place. Automatic sensors placed behind the pan can operate when the user leans forward, thus defeating the object of saving water.
- Ensure the toilet flush is within easy reach of a wheelchair user sitting in their chair and using their elbow or wrist to operate the mechanism.
Following hand washing, the wheelchair user may then wish to tidy themselves. A mirror at the correct height and position is required.
- Ensure a mirror is positioned within the facility to facilitate use by seated and standing occupants.
An occupant of the toilet may need to call for help. An alarm system is therefore of great benefit.
- Install an emergency alarm able to be operated from a seated or fallen position. Position the alarm reset switch within easy reach of the toilet seat in case the alarm was set off by accident.
It is important that lighting is always available as toileting may take some time. Accessible toilets often do not have windows so artificial lights switched from inside the facility are important.
Ultraviolet lighting (which is sometimes used in toilet facilities to deter drug use) can present difficulties for people including those who are diabetic and those who need to change colostomy bags.
In the event of a power failure the occupant may be in a state of undress. Emergency lighting inside the facility is essential or they will struggle to get back into their wheelchair.
- Ensure artificial lights are switched from within the accessible toilet enclosure and not reliant on movement detectors outside of the toilet.
- Install emergency lights within the accessible toilet cubicle.
Other design considerations
Some people collect urine in a bag which for a wheelchair user would be attached to the lower leg. Those able to stand can empty this bag into a toilet but for a wheelchair user, if the bag needs to be emptied by gravity, this is not possible.
Some people collect solid waste in a colostomy or ileostomy bag. A colostomy pouch is usually changed after every bowel movement; an ileostomy pouch is usually able to be emptied and changed every few days. A shelf is required to assist in this process.
A shelf is also useful for keeping things off the floor or for personal effects.
Heat emitters such as radiators contained within the toilet enclosure could be used as a support and if their temperature is not regulated, could injure users.
Some users will want to hang up a jacket or a coat before using the facility. A suitably placed coat hook is therefore essential.
Building Code requirement
Building Code clause G1 Personal hygiene:
G1.3.1 Sanitary fixtures shall be provided in sufficient numbers and be appropriate for the people who are intended to use them.
G1.3.4 Personal hygiene facilities provided for people with disabilities shall be accessible.
The way out of sanitary accommodation should be logical and clearly marked.
It is generally easier to find your way into sanitary accommodation than out as often all of the possible exit doors look the same. This can cause frustration and sometimes panic.
- Ensure exit doors (if installed) are colour contrasted on the exit side and signed appropriately.