When surgery is the only option.

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Every day, disabled women are choosing surgery because there are no usable toilets outside their home.

Sometimes it's an ostomy bag for poo or more frequently a supra pubic catheter.
A catheter allows urine to drain from the bladder [through a hole in the skin] into a
bag or through a valve into a bottle/toilet. It's a big life changing decision.

Getting surgery for a catheter is the most talked about topic within women's forums and social media groups.

Read above one woman's experience.

The reason is not often for medical purposes – but simply because toilets are not accessible / available. They don't have the right amount of space or equipment to be usable. Sometimes they aren't provided at all or are padlocked. If you need a hoist then you only have a choice of around 1000 toilets – across the whole of the UK or Northern Ireland. There may be none in the county you live.

Catheters can cause regular infections and several other medical problems – yet bring an element of liberation and the ability to leave the house. They don't remove the need to manage menstruation hygiene though and many women also choose contraceptives or surgery to control this (oral contraceptives pose a high risk for blood clots in women who aren't active) – because they can't get on the toilet.

Disabled women experience the most discrimination when it comes to using toilets. They take the most life changing health risks. This has to change.

Have you had surgery because of no usable toilets? Tell us in the comments below.

Helpful or not – petitions

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There are over 80 petitions on Change.org calling for signatures to back calls to governments and businesses for accessible toilets. Most are by individuals calling particularly for Changing Places toilets.

Are petitions helpful?

Psychologically petitions and demonstrations by disabled people and carers are useful – providing the 'I feel I am doing something rather than nothing'. People who sign genuinely want to say 'this needs to change'. However, the reality is that petitions rarely achieve results.

No amount of signatures is going to change the law or monitor adherence to building regulations. In the UK, the government have heard, via parliamentary debates, how we need accessible toilets. They end with empty promises.

As we speak the draft of revised access standards has been drawn up – setting British standards for what could be used in buildings which last over 50 years. They don't include any change to toilet provision. They are based on the dimensions of wheelchairs, for example, from 20 years ago. Petitions won't impact these.

Dilution of support

Petitions aim for x number of signatures …. people might sign one or two but 80? If campaigns were centralised into one petition there could be thousands of supporters rather than a few hundred.

Change in strategy

The movement to ensure toilets for all is disjointed. Often it's based on promoting the needs of children rather than the needs of disabled people of all ages. People with obesity, dementia and autism are often totally ignored. Many campaigns are based on the need for hoists and changing benches – yet we still have toilets being built that are supposed to follow strict building regulations, but don't for 'independent' disabled people. There are failings at every level. Equality laws do nothing to persuade businesses that disabled people need accessible toilets.

What can we do to actually make a difference?

  • Share a petition rather than recreate one for yourself
  • Look out for opportunities to comment on building regulation guidance, local access consultations, health consultations etc.
  • At every opportunity provide feedback about toilet access. Use social media, review websites, council feedback forms, patient feedback cards at hospitals etc.
  • Use formal complaints procedures.
  • Write to your MP
  • Provide witness statements for parliamentary debates

Sounds like a lot of effort? That's why it's easier to sign a petition and have our social guilt relieved – we've done all we can, right? Now everything will be ok?

No it won't – but deep down you know that.

Draft of BS 8300 -2 available for comment

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British standards are helping businesses thrive. Some of them define access for disabled people outside and inside public buildings.

What is a British Standard?

Standards define best practice in many different areas. They’re put together by groups of experts and come in a number of different kinds, from a set of definitions to a series of strict rules. 

… Standards are not the same thing as government regulations, but they’re often used in legislation to provide the technical detail.

(BSI, 2017)

Standard BS 8300 defines access requirements from ‘set down points’ in car parks to the distance to the toilet or width of lifts. There is a section about toilet access, dimensions, fixtures, fittings etc which is best practice. 
A new draft for BS 8300 is available to read and comment on. There are two parts – the toilet section is on 8300-2.

Link to draft BS 8300-1 and BS 8300-2 (enter 8300 in the search). 

Museums and accessible toilets

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Are museums no go zones?

Museum of London, Docklands

Have you ever been to a museum that hasn’t had a toilet for visitors, staff and volunteers? If it’s a medium to large museum – probably not. They are probably high on the list if not essential.

Disabled people are potential employees, volunteers and visitors, yet still so many museums fail to provide usable, safe toilets for people with access needs. 

I’ve been to hundreds of UK museums of all sizes, only 2 fully met my needs. If I am with my care assistants I can only visit places with hoists.

If a museum provides accessible and usable toilets for people, the benefits are perhaps obvious:

  1. Larger pool of employees to choose from
  2. Disabled and older people can visit
  3. More attractive to disabled and older volunteers
  4. More attractive to schools who have disabled teachers or students

This leads to increased community outreach, education, visitors and profits / grants.

Without usable toilets, museums and galleries are choosing not to welcome and exclude disabled people. 

We have accessible toilets

You have to be very ‘able’ to safely use ‘standard’ accessible toilets. You have to have either strong arms or legs (to transfer from a chair or stand/sit), good balance, good dexterity and grip to hold support rails. Many people are not that ‘able’ e.g. people with MD, MS, MND, arthritis, CP, paralysis, stroke, short limbs, learning difficulties, autism, anxiety … that’s collectively millions of people!!

Florence Nightingale Museum


This type of toilet might meet most of the standard criteria but only for the very able. 

Museums need to:

  • Audit standard toilets against the most recent recommendations for access 

This one below has a raised seat which is not part of access criteria and can make it extra difficult or impossible for wheelchair transfers. The toilet roll is high up and the emergency cord is wrapped around the support rail.

Horniman Museum

  • Install either a space to change toilet or Changing Places. These have essential space and equipment like a hoist and changing bench. 
  • Install a ceiling hoist over standard toilets to increase the number of visitors/staff who can only get out of their wheelchair with a hoist (like Lincoln Castle has below).

  • Advertise your facilities or people won’t go if they are not confident there is a usable toilet.
  • Show pictures of your toilets in access guides and provide clear signage.
  • Have regular reviews of toilet access.

It is still disappointing that so many museums exclude people. Most of the big museums across London for example do not provide usable toilets (notably Cardiff and Edinburgh have full facilities in key museums) .  When these London venues are approached they don’t want to know. 

“In Kent there are no museums with hoists in their toilets – so I can’t visit at all.”

Attitudes must change if disabled people are to get inside museums – it doesn’t matter how many tactile maps, quiet areas and ramps you have if people then have to worry if they will wet themselves and have a miserable stressful day out.

All about support / grab rails

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Taken from our guide (see links page) we look at the importance of support rails in accessible toilets. AD M is approved document M of the U.K. Building Regulations.

It is possible to have many layouts to allow for the provided dimensions and fixture configurations in AD M.
 

The general layout of a unisex accessible toilet is to have horizontal grab rails to both the left and right side of the toilet [AD M: S 5.8].

Heights, lengths and distance from the toilet / sink / mirror etc must be precise as described in AD M.
Vertical rails must also be provided in specific places.

How many rails do people need?

74% of disabled/older people use handrails. They can be used to pull/push up with or simply to lean on for stability.

41% of powered wheelchair users prefer the right side, 30% the left and the rest had no preference in a 2005 study.

Some people need a rail both sides and on the back wall.  The rails needs to be the right height, length, distance from the toilet/sink, thickness and colour.

An accessible toilet must  have at least 5 support rails with additional ones if the toilet is located some distance from the wall. 


Barriers introduced

As can be seen above, support rails can infringe on the transfer space and cause problems for some wheelchair users.

Solutions

  1. Assess your toilet – do they have the full complement of support rails and are they in the right place and the right length / height? 
  2. Mix it up – the standard suggests that if you provide more than one unisex toilet, a choice of layouts for left and right hand transfer should be provided. 
  3. The smaller the space, the more grab rails will get in the way for powered wheelchair users and carers – re-consider your design space. 
  4. Provide Changing Places toilets in addition to existing accessible toilets. The larger spaces to the left and right of a central toilet offer more transfer option angles for people who use powered wheelchairs, large walkers/ frames, or need carers to assist them.

FAQ: The RADAR accessible toilet key

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What is a RADAR Key?

The RADAR key opens toilets fitted with the RADAR National Key Scheme (NKS) locks. Toilets fitted with these are for the use of disabled people and are found all over the country (e.g. pubs, restaurants, leisure venues, tourist places, shopping centres, stations, airports etc).

Why is it called a RADAR Key?

The NKS scheme used to be administered by an organisation called RADAR (The Royal Association for Disability Rights). This has now merged with two other organisation to become Disability Rights UK. The name RADAR Key has stuck since then and is was going to be relaunched but this no longer appears to be the case.

What types are there?

There are two types – one with a small head and one with a very large head for people with grip or dexterity difficulties. Both are silver with the word RADAR RADAR_lockKey embossed on them and will fit into an NKS lock which looks like this:

They are long handled to bypass vandal protection blocks built into doors.

Who can have one?

Any individual with an impairment / medical condition who needs access to these larger toilets or hygiene facilities or needs facilities to assist mobility or navigation (such as hand rails, lower basin, contrasting colours, different toilet height or seat arrangement, changing table, hoist for example).

One downside is that you do not need proof of need to purchase one so parents and non disabled people can abuse the scheme.

Where do I buy a genuine key from?

You can buy genuine keys from http://www.disabilityrightsuk.org. At the time of writing (updated August 2016) they cost £4.50 (RADAR, when audited showed no profit in the keys – they actually made a loss at this price).

Disabled_Toilet_Key

Genuine RADAR disabled toilet key

The Blue Badge Company are also promoting a genuine key with a blue handle for £6.00 image

 

I have seen them for sale elsewhere – do they work?

Fake RADAR Key

Fake RADAR Key

There are hundreds of places claiming to sell ‘genuine’ keys including many prominent charities and mobility shops. One of the reasons for relaunching a new key is to avoid people being ripped of by fakes that may be so rough cut and out of shape that they don’t easily open toilets, if at all.

Tom Gordan from their sales team told me:

“Disabled people need genuine Radar keys because they are dependent on them to open what is often the sole toilet which they can use. 
Genuine keys genuinely work all the locks because they have extra machining processes and are more reliably cut and also more accurately cut.
Each one is tested on a radar toilet lock (not the padlocks which are a more basic mechanism) by a master locksmith to guarantee that a disabled person does not suffer.
Identification of genuine keys is easy – if it says “radar” on it, it is a genuine radar key. If it doesn’t then it is an inferior copy.
Including postage, the majority of the dodgy keys are sold for more than genuine ones direct from Disability Rights UK, so the confusion leads to those copies creating both awkward situations and extra cost.”

How do I find a toilet?

A booklet for regional locations is available on their website costing £3.50. However, it will cost you £70 to purchase all regions.

The majority of toilets use the scheme so it’s probably best to just follow signs to toilets/accessible toilets as anyone would do.

A new RADAR Key App will be available around September 2016 listing toilet locations.

Why are accessible toilets often locked with these in the UK?

Many places choose to install NKS locks on their toilets to keep them clean and reduce the chance of them being abused by people who don’t need to use them, vandalised or used for drugs, sexual activity or a wide range of other things.