Disabled Facilities Grants
Adaptation Design Guides
Home adaptations can increase independence, help to prevent falls, reduce the length of a stay in hospital and delay care home admission.
Adaptations can range from large scale extensions to fitting a grab rail in someone’s home, but a badly designed adaptation can be worse than no adaptation at all. These pages contain guidance from Foundations and a wide range of other sources to help you design high-quality adaptations that function well and look good too.
If you are a member of the public looking for help with home adaptations, please contact your local home improvement agency (opens a new window).
The Difficulty in Adapting Existing Properties.
In general, houses are not designed with disabled users in mind. Getting through the front door over a high threshold can be almost impossible and narrow corridors, circulation spaces and doorways are always a problem. The two most important rooms in terms of utility - the kitchen and bathroom - are often difficult to use.
Improving accessibility requires a return to first principles; to look at how the available space can be best arranged and utilised to give the best value for money solution. Planning and Building Regulations always have to be observed and finance can be restrictive.
This guide aims to improve the provision of larger adaptations by:
- setting out the process;
- placing the client at the centre of the design process;
- promoting joint working;
- balancing the needs and expectations of the client with value for the public purse; and
- understanding the space and design principles underpinning major adaptations.
This section is divided into 7 parts that complement each other to create the completed job.
For the purpose of this section we will focus on schemes funded by the Disabled Facilities Grant although much of the information will apply more widely.
Choice in the design of Adaptations
Adaptations funded by a Disabled Facilities Grant (DFG) are designed to meet an ‘assessed need’. The final design of the adaptation, particularly in complex cases where more than one building element is required, may not be what the client aspires to, and may even be something they dislike. Should the client have to accept something they do not like being done to their home and what is the role of choice in the design of state funded adaptations?
The Care Act 2014 changed the emphasis on how Local Authorities should perceive the ‘needs’ of the individual. Section 1 of the Act says that the social care authority has a general duty to promote the wellbeing of the individual, including personal dignity, physical and mental health and emotional wellbeing, control over day to day life, and suitability of living accommodation.
In all there are nine components to the definition of ‘well-being’ and to qualify for support the individual must fulfil a minimum of two. This doesn’t mean that a person can have whatever they want, but due regard must be given to their views, wishes and feelings.
In contrast, the DFG provided under the Housing Grants (Construction & Regeneration) Act 1996 is far more prosaic considering what is ‘necessary and appropriate’ against what is ‘reasonable and practicable’. A far more limited scope and one that typically provides little choice for the client whilst providing ‘best value’ (usually the cheapest option) for the public purse.
In the case of an adapted bathroom this will normally mean the provision of plain white tiling, entry level waterproof, non-slip flooring, and half-height shower screens. This can give a very ‘clinical’ feel to what is a family bathroom. The result may be that the client does not feel happy using the new bathroom as it simply confirms their increasing frailty; or is reluctant to invite friends and family into the home and therefore becomes increasingly isolated.
In the case of an adaptation for a child or perhaps an adult with a long-term spinal injury it might mean trying to meet the greatly increased care needs of the individual within the existing footprint of the house due to the maximum value of the DFG (currently £30,000). This can often lead to a compromise in terms of available space. Ironically, it is often the creation of additional space that is the critical factor in the success of any such adaptation. In this case the result is all too often that the family and carers continue to struggle to help the client effectively, the client is unable to navigate the home independently, and the extensive equipment that is designed to help their lives simply becomes a burden and impossible to store safely.
So, the choices engendered by the Care Act can be frustrated by the ‘needs’ of the Disabled Facilities Grant assessment. There is plenty of guidance published on how to deliver a successful adaptations service that meets the reasonable expectations of the client, including discretion provided by the Regulatory Reform Order 2002. On the other hand, sadly, there are plenty of Local Government Ombudsman judgements that demonstrate where this not happened.
Placing the DFG funds within the Better Care Fund was intended to lead to a better integrated, ‘person-centred’ system. The key to success lies in the quality of the assessment of the individual client that balances their reasonable needs and wants against the benefit to the public purse of providing support (in this case the adaptation).
A successful adaptation, i.e. one that is used, may reduce or defer other costs within the care system and therefore it is essential that the client is heard. It may not only be funded through the provision of a DFG, but by other public funds. All cases should be reviewed after an adaptation has been carried out to ensure that any care costs are reduced as a result of having the adaptation installed. It is also important that the effect on carers is recorded as evidence shows that installation of adaptations can considerably lighten their load, reducing long term stress and keeping the family unit viable for longer periods.
Of course, there are other options available to clients who aspire to an adaptation beyond which the local authority will fund. To accommodate this, many authorities offer what is commonly known as ‘Preferred Schemes’ by which a client can receive the notional amount for an adaptation and then pay any additional amount themselves. This is a creative solution that satisfies the Council’s need to manage their budget but also allows the client to achieve a higher cost adaptation that suits their aspirations. This is only an option if the client or family are able to fund the additional amount. In fact, the Housing Grant (Construction and Regeneration) Act 1996 recognises this compromise in clause 23(3).
Preferred Schemes in practice
Sometimes a client may wish to have a scheme designed which goes over and above what the Local Authority deems strictly necessary. In these circumstances the local authority would follow the following procedure:
- Assess which adaptations are “necessary and appropriate” and estimate the cost of those adaptations based on an approved schedule of rates or prices for similar schemes the council has approved in the past.
- Using the estimated cost and the client’s assessed contribution, the authority would notify the client of the amount of grant they could receive and any required features of the Preferred Scheme.
- The client will often need to appoint a Home Improvement Agency or their own architect to design the Preferred Scheme including the required features. The grant may include part of the fees involved in designing the Preferred Scheme.
- The client will need to seek the approval that the Preferred Scheme is acceptable, preferably before being submitted for planning and building control approval, and a detailed specification is prepared for pricing purposes.
- The approved drawings and specification should be sent to a minimum of two contractors for pricing.
- Once the application is submitted the grant will be calculated taking into account any assessed contribution and an approval notification issued.
- Once the approval is received by the Preferred Scheme may commence on site.
The design assessment stage of the adaptation process is one of the most critical aspects and it is important to gather the correct information. The discussions that take place with the client at this stage can determine whether the adaptation will be a success or failure.
Each client will be different with varying requirements and ensuring that these are correctly identified will be critical to the success of the project. The information that you receive will allow you to create a bespoke proposal for that client rather than a ‘one size fits all’ approach.
When should you contact a client? Many clients will have a preferred time of day to be contacted. This might coincide with their waking times or when care tasks are not being performed. Understanding a client’s routine is essential not only for planning their adaptation works but ensuring you are delivering a positive client experience.
Who is your client? A client is likely to have other professionals involved with the adaptation, including a care team, case manager, relative, solicitor or financial deputy. It is critical that you understand who has authority to make decisions (particularly those with financial implications), who the client is for the purposes of the contract and who you can discuss the case with.
Is it safe for your client to use certain equipment? In terms of the adaptations, the physical characteristics of the client are incredibly important. Whilst many may shy away from asking the difficult questions, knowing the client’s height and weight is very important to ensure the correct equipment is specified. Knowing the physical characteristics of the client will also ensure that any hoisting arrangements are fit for purpose and will not cause any health and safety concerns for carers.
If the information is not provided by the Occupational Therapist, you could consider testing the client’s reach. This helps to determine the level equipment should be placed at and is very important when considering the functionality of kitchens, bathrooms and utility spaces.
Level of Mobility
The reason the adaptation is being proposed is likely to be because the client has reduced mobility or another impairment that might place them at risk in the home. It is essential to determine whether the client’s perception of their mobility level actually matches reality.
There are some clients who do not want to admit they are having problems and might try and hide the extent of the condition. However, others might innocently not realise they can actually do more than perhaps they realise. In both cases, it is important to ensure the occupational therapy report is carefully considered against the client you actually meet during the visit. This will then allow you to identify any discrepancies, which are better dealt with at this early stage.
There are many different ways of classifying a client’s level of mobility but many will consider the following:
- Are they ambulant either with the assistance of a carer or a support aid?
- What walking aid do they have (e.g. walking stick, walking frame, wheeled frame)?
- Is the client reliant on a wheelchair?
- Is the wheelchair powered or manual?
- Is the wheelchair required indoor, outdoors or both?
- Does the client require hoisting?
The assessment should not only consider the level of mobility but also how long this can be maintained by the client. A client might be able to mobilise but for only relatively short distances and it is important to understand these limitations so that you don't place the client at risk. Some of the questions you might like to consider are:
- Can the client climb and descend stairs?
- Does the client need any support when climbing or descending stairs (e.g. rails, bars etc.)?
- How long can the client mobilise for before feeling tired?
- Does the client require the assistance of a carer or other person to help them mobilise?
- Is the client’s level of mobility likely to change in the future?
The questions considered above directly relate to physical mobility but other factors will impact on mobility. For instance, does your client have any other conditions (e.g. being colour blind, hearing loss, partial or full sight loss, epilepsy etc) that might influence the overall decisions that are being made (e.g. a stairlift might not be appropriate for someone who is likely to experience seizures on the stairs)?
The property to be adapted for the client may not just be a home for the client but also for the rest of the family. The adaptation proposal needs to consider all occupants’ needs for it to be truly successful. A good example is provided by a simple bathroom to wet room proposal.
The obvious solution for many clients is to remove the bath and replace it with a level access shower. This provides an excellent solution for many clients but may present issues where other family members enjoy bathing or have children. The loss of a bath can become a very contentious issue. Understanding these needs can allow the designer to input these requirements into the design or to manage the client’s expectations by explaining why it is not possible.
At the client interview stage, it is worth noting other members of the household and if they have any special requirements. This will also include pets who are often the number one consideration for many clients!
The daily functions are one of the most critical for a successful adaptation. The ability for the client to use the bathroom safely is essential. At the heart of the adaptation should be the central thread of making the client’s daily life easier.
When discussing with the client it is important to establish whether they can toilet independently, need assistance or make use of aids. Many clients might feel uncomfortable talking about this subject as it can be perceived as undignified. However, many toileting solutions (e.g. wash dry toilets) can often help the client regain control and turn it into a better experience.
Bathing and showering is another area of personal preference. Many adaptation designs provide for a bath to be removed and replaced with a level access shower. However, this overlooks the therapeutic effects of a bath and possibly a client’s preference. Understanding how your client bathes currently and their future aspirations is critical. This does not mean the client will get exactly what they want (perhaps due to limited budgets) but at least their expectations can be managed.
Personal hygiene questions will not only affect the design of the bathroom but will also impact on utility facilities and the juxtaposition of rooms in the property. A client who suffers from periods of incontinence might produce extra washing and there might be a need for a sluice room. The positioning of the toilet facilities will also be important to ensure the client is close to accessible facilities.
The Kitchen - Cooking and Eating
One of the key questions during the design process is to understand the client’s daily routine and what activities/roles they undertake. An essential part of any household is the preparation and eating of meals.
The kitchen is a high-risk area and the designer’s role is to ensure these risks are minimised whilst allowing the client to function in the kitchen environment. Central to this is getting an understanding from the client about what activities they would like to perform in the kitchen. Some clients may simply want to prepare a drink and a light snack, so extensive kitchen adaptations would be inappropriate. However, others might like to cook full meals so a fully accessible kitchen would be critical. Only asking the client about their aspirations will identify their individual requirements.
Preparation of meals, drinks and snacks can present significant design challenges. There are plenty of innovative solutions to facilitate safer use of the kitchen. These include rise and fall counters, accessible cupboards, slide and hide ovens, accessible appliances and adapted utensils.
Many families see a communal eating area as central to the home. The dinner table is often the hub of family life and making this accessible to the client can be critical. This might be simply considering circulation space around the table or might require the provision of a height-adjustable table. These simple changes can have a huge impact on family life.
Understanding a client’s sleeping arrangements is very important for a successful design. The designer will need to be aware of their specific requirements, including:
- What type of bed does the client have (e.g. single, double, king etc)?
- Does the client have a special bed (e.g. hospital profiling)?
- What are the dimensions of the bed?
- Will the client be sharing a room with another person?
- Does the client have any special considerations when they are asleep (e.g. close to a toilet, require oxygen, need a quiet environment, close to a carer etc.)?
All the items above will help the designer formulate a better picture of the client’s sleeping routine and requirements.
Each client will have varying degrees of involvement with household duties. The designer will need to understand whether the client need access to places like utilities, laundry appliances or cleaning cupboards. Only by understanding the individual requirements will the designer ensure money is not wasted on unnecessary adaptations.
The care regime for clients is a fundamental part of their daily routine. A day carer might not require any facilities but a ‘live-in carer’ will almost certainly need to be considered as part of the housing design.
The design assessment is a good opportunity to get a better picture of how the care team interact with the client. One of the key pieces of information is to establish how many carers the client has, how long they spend with the client and whether there are other privacy issues to consider.
From a design perspective, it is important to establish whether the client has or might need to have in the future a live-in carer. The client will find it easier to attract a good carer if they are able to offer good facilities to a live-in carer.
The rest of the family’s views are also important when designing for live-in carers. Many families want to try and maintain a level of privacy. This means that it is essential to consider whether a degree of separation between the carers and the rest of the family can be maintained. This might be by providing a separate entrance to the property or clustering of certain rooms together. Each case will be different and largely depends on the composition of the family (e.g. a single person requiring care is unlikely to need these additional considerations).
Clients are likely to own, use and need to operate a wide variety of mobility aids and equipment. This presents two problems for the designer: the first is extra storage and the second is space to adequately use this equipment.
- The designer should consider obtaining:
- The dimensions of any mobility equipment being used to include a turning circle (if appropriate).
- A list of all the equipment that is used or might be used in the future.
- Where in the house is the equipment used?
- Does the equipment require charging when not in use (this can affect power supply points)?
- Will the equipment require cleaning after use?
A successful adaptation will provide solutions that allow the mobility equipment and aids to be at hand when required but good storage when not in use. Another good source of information about mobility equipment is from the supplier who might be able to provide details about space requirements, storage, cleaning and maintenance.
Hobbies and Physiotherapy
When carrying out adaptation designs, it is very easy to focus on the immediate critical requirements of the client like access to the kitchen and bathrooms. However, many clients have interests or hobbies that may also influence design decisions. These hobbies may simply be for enjoyment but can also offer other physical benefits that might assist the client’s condition in the long term (an obvious example would be an activity like swimming).
Many clients will also have the need for daily or weekly physiotherapy sessions. These might be conducted away from the home at local facilities but often many client will have a programme that needs to be completed at home. Asking the client about the physiotherapy/rehabilitation requirements is very important to ensure adequate provision is made for the equipment. Again, the physiotherapist should be able to provide a list of equipment and indicate what space is required to use it safely. However, the suppliers of such equipment will be able to provide space standard guidance in relation to circulation space around gym/physio equipment.
Vehicles and Travel
Access to the house, particularly from a vehicle is very important. In many houses, this often presents an issue because driveways are too small or may not have off-street parking. There are some important aspects to consider as part of the design and to discuss with the client:
- What car or vehicle does the client have?
- How does the client transfer to and from the vehicle (e.g. side, rear, front)?
- Will the client be a driver and/or passenger in the vehicle?
- Are there any parking restrictions in the vicinity or shared facilities?
- How long does the transfer usually take?
- What is the primary entrance for the client?
Space and Design
Principally there are 3 types of extensions that will allow you to achieve a number of different space creating outcomes:
Single storey extensions - perfect for creating a ground floor bedroom and shower room. May be necessary to reconfigure the existing ground floor layout to achieve the best solution.
Wrap around extension - an 'L' shape build to either the side/rear, or front/side of your property. Can be required where extra space is required for wheelchair access.
Double / multi storey extensions - used increasingly where there is insufficient space for a single storey extension, these extension types provide additional downstairs living space as well as more bedroom space upstairs, but usually require a through floor lift for disabled access.
If additional space is the end goal you may have to consider a conversion. Conversions are typically suited to those looking to create an additional habitual room but already have the space suitable to house it i.e. a loft space, garage or basement.
Similar to extensions having a solid understanding of what you need your conversion to achieve is key as each type of conversion suits different wants, needs and desires.
Loft conversions are principally the conversion of choice if you are looking to create an additional bedroom in your home – but with limited accessibility. Can be used to give a separate bedroom for the sibling of a child with challenging behaviours.
Garage conversions are also a popular solution. Perfect for creating a smaller ground floor bedroom and/or shower room. External garages will need carefully assessing to see if they are structurally suitable to become a habitable space.
Basement conversions are typically the least popular form of conversion and this is often due to what you want the new space to achieve. Although they are rarely part of an adaptation project they may create extra storage space.
Planning Permission & Permitted Development
This is probably one of the biggest concerns for any large scale home adaptation project. When do you need to obtain planning and what do you need to obtain it for?
Typically planning permission only comes into play when considering a large scale extension project or specific conversion project but even then there are areas of exemption. Permitted development is a relatively new building law, referred to as a ‘relaxed’ version of planning permission.
New laws introduced in October 2008 mean that in many cases, an extension or addition to a home is considered to be permitted development, not requiring an application for Planning Permission, subject to the following limits and conditions:
- No more than half the area of land around the "original house"* would be covered by additions or other buildings.
- No extension forward of the principal elevation or side elevation fronting a highway.
- No extension to be higher than the highest part of the roof.
- Maximum depth of a single-storey rear extension of three metres for an attached house and four metres for a detached house.
- Maximum height of a single-storey rear extension of four metres.
- Maximum depth of a rear extension of more than one storey of three metres including ground floor.
- Maximum eaves height of an extension within two metres of the boundary of three metres.
- Maximum eaves and ridge height of extension no higher than the existing house.
- Side extensions to be single-storey with a maximum height of four metres and width no more than half that of the original house.
- Two-storey extensions no closer than seven metres to rear boundary.
- Roof pitch of extensions higher than one storey to match the existing house.
- Materials to be similar in appearance to the existing house.
- No verandas, balconies or raised platforms.
- Upper-floor, side-facing windows to be obscure-glazed; any opening to be 1.7m above the floor.
- On designated land** no permitted development for rear extensions of more than one storey.
- On designated land no cladding of the exterior.
- On designated land no side extensions.
*The term "original house" means the house as it was first built or as it stood on 1 July 1948 (if it was built before that date). Although you may not have built an extension to the house, a previous owner may have done so.
** Designated land includes national parks and the Broads, Areas of Outstanding Natural Beauty, conservation areas and World Heritage Sites.
This means that in most cases, an extension will only require Building Regulation approval via the Local Authority, rather than full Planning Permission.
However, there are still cases where Full Planning Permission may be required and if your proposed extension does not meet with the previous limits and conditions, you will need to make a formal application to your local council before commencing work.
Similarly, new laws introduced in October 2008 mean that in most cases, Full Planning Permission may not be required for loft, garage or basement conversions unless you intend to alter/extend the existing roof space to such a degree that it exceeds specified limits and conditions or you are transforming/changing a space that was previously non-habitable to a habitable.
Instead, your proposed adaptation may simply require Building Regulation approval or permitted development in order for the works to be approved.
But, there are still cases where Full Planning Permission may be required and if your proposed conversion project does not meet the limits and conditions set out, you will need to make a formal application to your Local Authority before commencing work.
To find out more about Planning Permission visit: www.planningportal.gov.uk.
Within the Planning Permission or Building Regulations rules, there will be certain conditions and requirements relating directly to fire safety. For obvious reasons, these are of paramount importance and a great deal of planning will be needed to ensure these requirements are fully met when the design is first drafted.
The areas that are covered by fire safety regulations include things such as:
A full mains operated system will be required, usually with a minimum of one alarm/detector on each floor of the house, rather than just in the new/adapted room. Along with all the other electrical work, these should be installed by a registered electrician.
The doors into and within the new/adapted room will be required to conform to a certain standard with regards to the time they are expected to hold back a fire. Usually, ’30 minute’ fire doors are specified with your Planning Permission or Building Regulation rules.
The insulation used throughout the new/adapted room, be it for the floor, the ceilings or even the walls, will need to conform to certain fireproofing standards.
A means of escape in the event of a fire will need to be provided within your new/adapted room. Dependent on the usage, size and type of room you have, you may have to have a certain sized and positioned window for this.
Britain is traditionally a nation of bathers, and although the concept of showering is gaining in popularity, many people still far prefer a bath. But for people with mobility problems who cannot safely manage a bath, a shower adaptation will usually become the preferred option. For some a shower over a bath will be suitable, and for others the easiest way to provide a shower is to simply install a standard tray. But this will still leave a 150-200mm step to negotiate.
An assessment will be required by an Occupational Therapist (or a supervised Trusted DFG Assessor), who will have knowledge of the user's physical capabilities and their longer term prognosis.
In many cases the only solution is to remove the bath and provide a level access shower area.
The shower area
The traditional three foot square shower cubicle with a step down or raised base is outmoded and impracticable for most. Ideally there should be no changes in floor level between the shower area and that adjoining it apart from a minimum fall to carry the water to an outlet. There should be no fixed screen walls or partitions enclosing it.
Where a shower area is provided for a disabled person, it is normal for Social Services to provide a wheelchair to be exclusively used while showering. This allows dressing and undressing to take place within the bedroom, so decreasing the space required within the shower room - essential where an standard size bathroom is being converted.
For economic use of floor space, the drainage from a shower should be so devised as to enable the shower area to form part of the circulation space within the room. Where there is a screeded concrete floor, the whole of the shower area could be laid to a slight fall (between 1:20 and 1:40) towards a round gully with its grating set flush with the lowest point. To prevent any water flooding out through the door it is preferable for the gully to be positioned on the opposite side of the room.
Vinyl sheet or ceramic tiles provide an acceptable floor finish, so long as they incorporate non-slip properties. Carpet should be avoided as it does not dry or clean so readily and also makes wheelchairs more difficult to manoeuvre.
Continuous gratings around a shower area are not recommended as they can be easily dislodged creating a hazard for the ambulant disabled and possibly interfere with the movement of a wheelchair.
Where the floor construction restricts or prevents the necessary fall to the drainage outlet one of a wide range of level access shower trays may provide a suitable solution. Trays are available in all shapes and sizes, making careful selection very important.
For a traditional boarded timber joist construction, one of the best solutions is to cut out the floorboards and use a shower former set down onto the joists. Vinyl sheet with welded seams is the laid across the whole floor to prevent any water leaks.
Where floorboards cannot be so easily cut away or below floor drainage is not available there are many glass fibre trays available that require little or no excavation of the existing floor. Such trays usually include a small ramp on entry in order to prevent the escape of water, but may be a potential obstruction to circulation.
The ideal shape of tray for a wheelchair user is a minimum of 1.0m square, with 1.2m being preferred. Bath-shaped trays for easy replacement of baths are available although a standard bath width of 700mm is not usually sufficient for most users. Smaller trays are available for ambulant users.
Where it is impossible to excavate any of the floor, even for drainage pipes there are two possible options - to use a tray with shallow steps up to the shower area where the user is able to manage them; or to use a water pump.
A pump may be used to suck up water from glass fibre tray and transfer it to the waste outlet. Although not an ideal solution, a pump may also be useful where the shower area is remote from main drainage runs.
In order to reduce splashing, which tends to increase hazards by unnecessarily extending the wet area of the floor, curtains hung on runners should be provided that can be pulled out of the way when the shower is not in use. To prevent water escape the curtains should trail to the floor, which will necessitate a longer than average drop to allow the rail to be sited above head-height. Weighted hems will also assist with the retention of water.
Where the disabled person requires assistance in the shower, half-height glazed screens may be installed to prevent the carer from taking taking the shower as well.
The shower control
The control of the flow of warm water must be within easy reach of the user's sitting position, but placed so as not to be an obstruction. For some users two shower sprays are essential, the first to play warm water over the body and the second for more detailed washing.
A thoroughly reliable thermostatic mixing valve is essential and for those with skin acutely affected by temperature change, extra sensitive thermostat elements should be specified. It is also important that the valve should stop the flow of all of the water and not just the hot as a blast of cold water may be just as bad.
A shower rose and flexible hose mounted on an adjustable vertical rail should be provided within easy reach and without obstructing movement.
Several manufacturers produce a package designed for disabled users including extended riser rail and hose to allow use by disabled and able-bodied users as well as an extended lever for the heat control.
The water closet (toilet)
The main criteria when specifying a w.c. is the height of the seat. For a wheelchair user the seat should ideally be the same height from the floor as that of the wheelchair (i.e. around 510mm), whereas a normal height pan will normally suffice for most ambulant disabled users. For those suffering from stiff or painful joints and find it impossible to lower and raise themselves from a standard toilet, supplementary seats are available to raise the level as required.
If a particular seat height is required then a cantilevered pan may be preferable so long as particular consideration is given to the careful detailing of supports. Otherwise a shaped timber plinth secured beneath a normal pedestal pan should be quite adequate.
The space required around the w.c. will again depend on the user. An ambulant disabled user generally prefers supporting rails close by whereas a wheelchair user needs space to manoeuvre alongside. The approach and space required for any wheelchair user will be specific and the advice of an Occupational Therapist will be required.
While a close coupled suite may be considered the more attractive, a separate pan and cistern with connecting flush pipe is far more adaptable. Both the horizontal and vertical distances between the pan and cistern can be easily varied to suit the user, and where space is tight a high-level cistern with flush chain can be used to great effect.
The toilet seat
The strength, material and shape of the toilet seat are important considerations. If the disability is not too severe a standard plastic seat will be acceptable, so long as there are no accentuated raised edges that may impede transfer.
A more severely disabled user will generally have less control of their body weight, and a sudden impact on the seat must therefore be anticipated. The stresses sustained from a horizontal wheelchair transfers on units designed to accept weight from a vertical position may also be excessive. Some also find the normal ring seat insufficiently wide, and visually insecure, to use as a hand rest when transferring.
The wash basin
Particular care needs to be taken in selecting wash basins. Some models reputed to have been specifically designed for the disabled have been found to be quite unsuitable in practice.
When selecting a basin for a wheelchair user, two important requirements must be met. Firstly the arms of a wheelchair should not prevent the user from getting sufficiently close to the basin; and secondly, the front of the basin must be an adequate distance from the back wall to allow for projecting footrests and feet. This obviously makes the use of pedestal supports unsuitable.
Whatever the user's disability, the provision of space around the basin will allow its use as dressing table space for shaving, hairdressing and make-up and provide ready access to toiletries. If there is space available, a vanity bowl set into a formica faced blockboard sheet of appropriate size is ideal.
The height that the basin is set to is crucial to its utility; in most cases this should be agreed with the user during fitting. Where there is likely to be a requirement to adjust the height over time, an adjustable fitting may be considered with flexible couplings to the taps and waste..
Where greater flexibility is needed, there are basins available which are fitted with hydraulic rams that allow the user to adjust the height at the touch of a button. This is very useful if there are multiple users or where a single user alternates between using a chair and standing.
The bidet offers those whose disability prevents them from being fully able to cleanse themselves, the ability to do so with some independence and dignity.
The standard bidet is, however, normally too low to allow direct transfers for wheelchair users; requiring the whole unit to be raised on a base. Due to the use of hot water around particularly sensitive areas, thermostatic control of the water temperature should also be included.
A modern alternative to the traditional bidet is the combined w.c. and bidet, which can include remote control and warm air drying facilities. On most models a spray head is positioned beneath the user when required and retracts after use. Complete units or conversion kits for existing toilets are available.
Heating, lighting & ventilation
As most disabled people feel the cold more than the able-bodied, the bathroom of a disabled person should always have the provision for the maintenance of a comfortable room temperature. This is particularly important in the shower area. Where mechanical ventilation is used, radiant heat sources are recommended.
In order to prevent a build up of steam while the shower is in use and to keep the room free of condensation and mould growth, it is important to install an adequate ventilation system. Use of wall, window or ceiling mounted mechanical extract fans is advisable, either controlled by a humidistat or connected into the light switch.
Fans should be carefully positioned so as to provide the maximum amount of air circulation within the room. As most air will be sucked in under the door, the fan should be positioned in the opposite corner of the room. If this brings the fan within the vicinity of the shower a low-voltage unit should be installed.
Due to the amount of steam generated by a shower, a sealed light unit should always be installed. Florescent or LED fittings provide a long life-span and reduced consumption.
It is important to protect the walls surrounding showers and wash basins from water penetration. Ceramic tiling is usually the most appropriate solution. White tiles are cheapest but look quite clinical. There is a wide variety of other colours and patterns available within a budget.
Where the user is, or may be, visually impaired, a contrast should be sought between the sanitaryware, the walls and the floor, so necessitating the use of more colourful tiling.
Ramps and other forms of disabled access are usually the most visible adaptation you can make to someone’s home. And yet in most cases their design is based on function rather than aesthetic. This section aims to improve the design of “facilitating access to and from the dwelling” funded by Disabled Facilities Grants in England.
However, design isn’t just a question of aesthetics. In 2013/14 the National Trading Standards Board introduced a Victim Impact Survey for all new victims of doorstep crime, to examine the nature of victims, the impact of such crime on victims, to identify contributory factors to victimisation, and to identify prevention opportunities. They found that 43% of victims had a handrail / grab rail, ramp to their door, or a key safe for use by carers. Alongside other evidence, this strongly suggests that some offenders may use these items as a means of identifying vulnerable residents.
There are three main ways of providing access to the home where steps limit accessibility:
- a ramp;
- a lift; or
- landscape modifications
Landscape modifications means the redesign and regrading of the path between street/garden and the front/rear/side home entrance to enable a continuous walkway (path) with an incline of 1:20. A properly designed landscape modification may not require handrails, can incorporate replanting and be designed to fit in with the façade of the home and reduce garden maintenance.
The provision of graded walkways has not been widely used in the UK home adaptations sector. This page provides an overview of the benefits of landscape modification and provides tips on designing best practice landscape modifications.
For all references and further information on landscape modification, please refer to the original published paper titled “Landscape modification as an alternative to ramps and lifts in the home” from the Australian Home Modification Clearinghouse website www.homemods.info. Download it here (opens a new window) (Opens in a new window).
Benefits of a landscape modification approach
A landscape modification offers a number of benefits over ramps and lifts. A landscape modification can be designed to blend with existing architecture. This maintains perceived house values and avoids obvious signs of vulnerability. Also, accessible design features can be applied, enabling a holistic approach to access from street to front door and throughout a garden.
A holistic consideration of the landscape in combination with the entrance of the home can achieve:
- Level entry access for all who live and visit the home.
- Improved accessibility of the garden.
- Improved functionality of the garden by reducing maintenance.
- Improved aesthetic of accessible pathway and entrance.
Where is landscape modification appropriate?
There will be cases where a re-landscaped, accessible front entrance solution is possible. The ability to modify the access through the garden is determined by the type of home (in particular the building’s relationship to the street). Other considerations include site features, including available land area, existing site, vegetation, topography, water drainage and run-off, existing services and soil conditions.
Is landscape modification more costly than other access options?
There is little research investigating the cost comparison between landscape modifications, ramps and lifts. In general, the steeper the land around the home the more complex and expensive a landscape modification would be. On flatter sites grading a tonne of topsoil is likely to cost much less than edging kerbs and handrails.
Designing a landscape modification
For a walkway to be considered accessible, the gradient (slope) must not be steeper than 1:20. A gradient steeper than 1:20 would be considered a ramp and require all associated ramped requirements such as handrails and kerbs.
Crossfall is the slope across a width of a pathway. Some crossfall is required for drainage purposes but too much will make navigating an incline difficult. Crossfall across a pathway should be no steeper than 1:40.
Rest platforms (landings) should be provided along an accessible route between street and front door. The number and size of landings will depend upon the length and design of a walkway.
The surface finish of a walkway is important and must be stable and non-slip with no stepping. This is important where concrete sections join on a pathway, and also in the correct laying of bricks and pavers. Abutting surfaces should have a maximum of 3mm height difference.
Thresholds and entrances require a level platform area to allow for rest, manoeuvrability for turning, accessing keys, placing bags and opening doors.
As a best practice in accessible design, a front entrance or front threshold will benefit from weather protection as well as enough level space to allow for manoeuvring or storage of a mobility aid.
Planting of the front garden
An accessible landscape can be low maintenance, requiring minimum care to maintain plant growth and weed management, that will not easily grow or creep onto walkways becoming an obstruction or hazard.
Modifying a front or back garden is an opportunity to improve plant types, replacing any toxic plants or weeds with low maintenance alternatives.
Inclusive garden design elements
Modifying the front garden landscape of a home gives the opportunity to improve levels of participation in the garden. This can be achieved through the incorporation of a number of design elements aimed at enabling an outdoor garden experience for all and might include:
- Raised and vertical gardens - providing gardening and horticultural access for those in a wheelchair if unable to kneel to floor level.
- Considered selection of sensory plants for the visually impaired.
General garden and utilities access
Consideration should be given to accessibility for lawnmowers and wheelie bins.
Poor illumination of a walkway will contribute to the likelihood of falls. Lighting that defines the pathway edges and reduces glare will improve safety and negotiability.
There is an untapped potential for graded walkways to provide accessible home entrances within the provision of home adaptations. This page outlines a range of important aspects of successful residential landscape modification.
Landscape modification has the potential to provide an accessible solution that:
- is fully accessible for people who use a wheelchair or mobility aid;
- can be designed to cater specifically for visually impaired people;
- is sensitive to the existing architecture of the home;
- maintains a garden aesthetic; and
- provides opportunities for improving a garden’s design and reducing ongoing maintenance.
In addition to these benefits, a landscape modification approach has none of the negative side effects of a ramp or lift installation, such as increasing vulnerability and being an eye-sore in the front garden. This further highlights potential for a landscape solution to be considered as an option when home adaptations are being carried out.
Before starting to design a ramp it is vital to know the difference in levels between the start point and floor level of the house. If you don’t have professional surveying equipment, the next best thing is a spirit level with a laser on a tripod, which you can get for about £25.
Set-up the tripod where you want the ramp to start and make sure it is level. Point the laser at the door where the ramp will end. You will need to measure:
A: The height of the level above the existing ground
B: The height of the laser light above the floor level at the doorway
C: The horizontal distance between the level and the doorway.
Try to measure C as close to horizontally as you can - measuring the length of a sloping path can give a different measurement - especially on a steep slope.
The difference in levels is A-B.
The existing gradient is 1 in (A-B)/C
Use this handy calculator to work out the difference in levels and existing gradient:
From the difference in levels, use this calculator to work out the length or ramp required based on your chosen gradient:
Regulations and guidance
For detailed information on the design of ramps and handrails see this handy guide from Charnwood Borough Council.
Level Access Thresholds
It can be tricky business to get the design of a level threshold of a property right to make sure it isn’t subject to water ingress or damp.
LABC have devised a quick step by step guide to installing effective level thresholds.
You can even download an easy to understand guide to installing thresholds on your build.
The kitchen is an area that creates many problems for architects and designers. As a consequence of having to work with buildings that have been built with traditional construction methods and processes, trying to salvage a kitchen layout compatible with the needs of a disabled user from the conventional standards for space, heating, plumbing, electric, etc., is not easy.
The golden rule in kitchens, regardless of their size, is one of ergonomics, i.e. how easy it is to work in them. Quick and easy movement between the intensive work areas is key, with equipment stored in easily accessible places close to where they will be used.
This page provides general design guidance and should not be used as a checklist for a Disabled Facilities Grant application.
Types of layout
While 'U' shape arrangements make the best use of space available, an 'L' shape kitchen layout is generally the most practical for all types of user. One or two-sided (galley type) layouts should be avoided, as they force the less able user to make more movements than necessary.
In accommodation designed for 1-2 less able people, there should be at least a 4.8 m run of 600 mm deep units, including a hob, oven at worktop height and cupboard storage. When 3-6 people are considered, this may increase to a 6.6 m run. Provision should also be made for an eating area where there is not a separate dining area.
Ambulant disabled users
For ambulant disabled users, additional circulation space is needed giving at least 1200 mm between units and work surfaces on opposing walls.
The optimum worktop height is approximately 150 mm below the user's elbow. This will minimise any strain on the back or shoulders when working in the kitchen. This usually gives an optimum work surface height of around 850 mm for a disabled user.
A place to sit down and work in the kitchen should be allowed for. This could be a table, free-hanging worktop or a pull-out shelf. To allow the best use of wall cupboards, these should be placed at 1300 mm from floor level with the top shelf being no higher than 1650 mm. Refrigerators should ideally be placed in a housing with the top shelf no higher than 1500 mm and the bottom shelf no lower than 500 mm.
A kitchen designed to be used solely, or in the main, by a wheelchair user differs from both the conventional and those for the ambulant disabled. The following features are very important:
- Large areas of free space
- Separate hob and oven
- Free space underneath work areas
- Greater concentration of work areas
In order to provide a turning circle for wheelchairs, at least 1300 by 1300 mm of free space will be required, with up to 1500 by 1500 mm necessary for larger chairs. Ergonomically, base units of around 530 mm high will increase turning space by allowing footrests to pass underneath - an essential feature for small kitchens. This size of base unit also provides the optimum comfortable reach.
Worktop height should be set 250 mm higher than the wheelchair seat, usually giving a height of 750-800 mm from floor level. Post-formed worktops are recommended, edged on all four sides and sealed underneath, giving a perfectly smooth finish. This ensures that clothing and cuffs do not get caught on the work surface, knocking the user off balance.
Pull-out worktops can can be useful, with some manufacturers supplying worktops with cut-outs for mixing bowls if required.
The sink, hob and a preparation area should have no units underneath so as to facilitate access. These areas should also be in close proximity to each other and be continuous so as to avoid excess manoeuvring.
Wall units should be fitted to provide the optimum use of storage space. In most situations, they will only be accessible by chair users if they are placed over areas of free-hanging worktop. The lower shelf of the wall unit should be around 1220 mm from the floor and the top shelf no higher than 1420 mm.
Trolley units are one of the most useful extras in a kitchen. They compensate for lost storage under the sink and preparation area, while providing additional work areas at lower level. This type of unit also enables anyone with limited strength in their arms or hands to move full saucepans from the sink to the hob, for instance, with a minimum of effort. Braked castors are an additional safety feature worth consideration.
Refrigerators should be placed in housings with the top shelf no higher than 1300 mm and the bottom of the refrigerator no lower than 400 mm from the floor.
Sinks should have a shallow depth of between 125 and 140 mm to make it easier for the wheelchair user, or someone sitting down, to reach things in the bottom. This also makes it easier for anyone with limited strength in the hands to lift a saucepan full of water, for instance, out of the sink and onto the worktop. Heat insulation should be provided to the underside of the bowl to eliminate the possibility of the user's legs being scalded. Square sinks are better than round ones for fitting saucepans into.
Waste disposal units have obvious advantages, but when access is required underneath the bowl by seated users, they may be an obstruction. It is important however, to have easy access to a dustbin near the sink. If there is no space available in cupboards underneath the worktop, then a mobile trolley with a built-in dustbin may be considered. This can then be placed in any convenient position.
Taps should be quarter or half turn so that they are easy for arthritic hands to turn and preferably ones which offer handle extensions as an optional extra. The tap itself needs to be positioned, so that if a saucepan is placed in the sink, it is easy to swing the tap over and to position it accurately over the pan. Many older people are not able to hold a saucepan full of water under a tap.
Sockets should be positioned at 1100 mm from floor level to the top of the socket. Ideally, in wheelchair kitchens, there will be no base units underneath the worktop at this point to restrict the user's reach. If this is inevitable, or the user has limited reach, consideration may be given to mounting the socket into the fascia below the worktop or into a false drawer panel in a base unit.
In general as many sockets as possible should be installed, especially if the user has severe mobility or reach problems. Sockets for built-in appliances should include easily accessible remote switching in case of emergency.
Provision for multiple users
Another way to accommodate multiple users in a domestic kitchen is with units that are able to wind up or down. Such frames allow sinks, hobs, ovens, storage cupboards and worktops to be infinitely adjustable.
These units can be adjusted in height manually with a simple winding handle, or by means of an electric motor. Whilst adding to the cost of the kitchen, these units do reduce the need to make provision for different types of user, which in itself is expensive in terms of cost and available space.
Such an arrangement also overcomes the psychological aspect of segregating users whose only real difference is their ability to overcome the obstacles a designer has left for them.
Perhaps one of the most important points when designing a kitchen for someone with a disability is not to let the appearance of the equipment make the room look too clinical. If special units are required, look for a range which is as attractive as conventional units and which offers a choice of finishes.
When designing for people with visual problems, a good contrast between dark and light, such as between door and handle, can make it easier to see.
Large chunky handles are important, to offer a comfortable grip to open doors and drawers. D-shaped handles are the best, and should be fixed down on both sides so that cuffs do not get caught in the middle.
Ovens and hobs
It is generally accepted that a separate oven and hob arrangement will suit most users. In fact, for wheelchair users it is considered dangerous to use a free standing cooker. Important features to look for are non-tilt shelves and easy-to-use controls. Where the designer has knowledge of the specific needs of the user, adapted controls may be included.
Side opening ovens must be used whenever possible to allow complete access to the oven contents. A pull-out worktop underneath or to the side of the oven complements this arrangement. The argument that pull-down oven doors protect the user from the heat of the oven is not valid, as the user is more likely to burn themselves on the back of the door when reaching in.
The oven should be placed, where possible, in a housing which has a variable height shelf. This allows the oven to be set at the optimum level for the user, while providing flexibility for a worsening condition or other users.
When specifying a hob, the emphasis has to be on safety and ease of use. Inset hobs with controls set close to the front of the hot-plates / burners are to be preferred. Remote control panels can be used for those with severe reach limitations but are are not recommended for the majority of users, as they can double the cost of the installation.
Halogen hobs have the advantage that the burners will cool down almost as soon as they are turned off. This is a good safety consideration. The burners heat up quickly too, which means that they can be more economical to run.
It is generally considered that on a safety aspect alone, electric hobs should be preferred to gas. There are different views on which fuel actually cooks better, but the designer has to weigh up the risk of burns from radiant rings or elements against open flames and the possibility of leaking gas.
Whichever hob or fuel is used, there must always be space left for the setting down of pans on both sides of the hob, which means fitting well away from walls or making full use of pull-out worktops and / or mobile trolleys. Where possible, worktop savers should be used in this area to protect the work surface.
Microwaves can be useful in small kitchens where space does not allow for a separate oven and hob arrangement. Combination microwaves will enable the user to prepare most types of meal and as with almost all microwaves, the side opening door is an advantage.
In poorly ventilated kitchens or open-plan arrangements where cooking smells and steam can easily escape into the living / dining area, air extraction is essential. Having the cooker against an outside wall will be useful when fitting the extractor.
The recommended height for an extractor unit is normally 600 mm above the hob for electric and 700 mm for gas. Where the hob or wall units are adjustable, the height of the extractor should also be variable. Flexible vents can be covered with adjustable cover boxes which match the rest of the kitchen range.
Where a wheelchair user may not be able to reach the extractor controls, a heat activation should be considered. Another more expensive arrangement would be to spur the switch so that it can be operated from the worktop fascia, but only in the most severe cases.
Washing machines and dryers
Except in the case of compact washers, these appliances invariably result in an overall working height of 900 mm when built under the worktop, above that recommended for wheelchair users. This makes it logical to group such appliances together where the remainder of the work surfaces have been set to a lower level.
Often the kitchen will be used by able-bodied as well as wheelchair users anyway, so necessitating a separate work area at between 850 and 900 mm high.
It should be noted that most washers have left-hand hinges doors and if placed on the extreme right hand of a closed elevation can create access problems, particularly for wheelchair users. The positioning of tumble dryers is not so important as most have reversible doors.
Ideally, if space allows, a utility area should be used to locate the washer and dryer, thus keeping the kitchen free for cooking, preparation, etc.
The dishwasher is a useful labour-saving device, particularly for disabled users. The appliance is best placed close to the sink, and care has to be taken if a built under arrangement is chosen, so as not to interfere with the flexibility of the kitchen units.