BRE Changing Places Toilets

BRE

Changing Places Toilets

Report prepared by: Building Research Establishment BRE Scotland

Orion House

Scottish Enterprise Technology Park East Kilbride, G75 0RD

Dr Stephen L Garvin, Construction Director Katy Hunter, Consultant

The opinions expressed in this report are those of the author.

Report commissioned by:

Directorate for the Built Environment Building Standards Division

Denholm House

Almondvale Business Park Livingston EH54 6GA Tel: 01506 600 400 Fax: 01506 600 401 e-mail: [email protected] web: www.scotland.gov.uk/bsd © Crown Copyright 2012

Applications for reproduction of any part of this publication should be addressed to: BSD, Directorate for the Built Environment, Denholm House, Almondvale Business Park, Livingston, EH54 6GA

This report is published electronically to limit the use of paper, but photocopies will be provided on request to Building Standards Division.

Contents

3U  ULandscape of Changing Places ToiletsU 8 

U

4U  UChanging Places Toilets CriteriaU 21 

U 5U  UCost BenefitU 23  U 6U  UOther legislationU 37  U 7U  UDiscussionU 39  U 8U  UConclusionsU 45  U 9U  UReferencesU 47  U

Appendix 3.1: Database of Changing Places Toilets in ScotlandU 48 

U

1

Executive Summary

BRE have been commissioned by the Building Standards Division (BSD) of the Built Environment Directorate, Scottish Government to undertake a research project to inform on the requirements and installation criteria for Changing Places toilets in non-domestic buildings.

A Changing Places (CP) toilet is a larger, combined toilet and changing facility which addresses the needs of people for whom standard accessible toilet accommodation is inadequate or impractical to use. Standard 3.12 (Non-Domestic) of the Scottish Building Standards requires every building to be designed and constructed in such a way that sanitary facilities are provided for all occupants of and visitors to the building. Facilities should be provided in a form that allows convenience of use without posing a threat to the user’s health and safety.

The provision of CP toilets are not currently required under the building standards however, they are promoted as ‘good practice’ within the introduction to standard 3.12 of the Non-Domestic Technical Handbook.

This report gives details of the findings of research into the requirements and installation criteria for CP toilets in Scotland. A review of the current CP toilets in Scotland has been completed and a database of current provision has been compiled. A survey was developed and agreed with BSD before being circulated to a contact for each location with a CP toilet. The requirements for the facilities have been compiled in the report using the main sources of reference. A cost-benefit analysis of CP toilets over existing sanitary facilities has also been carried out.

The following points have been concluded from the research:

• A review of the current provision of CP toilets in Scotland has found that there are at least 77 facilities. These are spread around the country, but there is a concentration across the central belt. The first of these CP toilets was installed in 1996.

• A database of CP toilets in Scotland (known current and future provision) has been developed from three existing sources of information. The database is considered to be accurate and represents a good indication of overall provision in Scotland.

• There are 14 CP toilets that are currently planned, although half of these are within one local authority.

• The drivers for the facilities are varied, but include legislative reasons such as the impact of the Equality Act 2010.

• The criteria for CP toilets include equipment, space, security, hygiene and signage. These are set out in BS8300 and other resources on CP toilets (the CP toilets consortium, PAMIS and the Learning Disability Alliance Scotland).

• The survey of current CP toilet facilities indicated that none of them met all the criteria. However, a number were able to meet most of the space and equipment requirements.

• The survey of stakeholders indicated that CP toilets and accessible toilets should preferably not be combined, but both types of facility are needed. There are usability aspects for independent wheelchair users and potential health and safety issues.

controlled in several CP toilet facilities by RADAR keys or through building management. Building owners would tend to be risk averse and to therefore take measures to avoid damage and nuisance, and their associated costs.

• The cost of the installation of a CP toilet was estimated by the survey respondents to be anything from less than £5,000 to more than £40,000. The research therefore built up a cost model for five types of buildings. Many of the costs (equipment, etc) are the same no matter which building type is considered, the main variable being the square metre construction costs for different building types.

• The capital costs for the CP toilets were estimated to be between two and three times that of an accessible toilet. The costs over a 60 year lifetime could be around four times higher.

• The research has determined that there are 20,000 potential CP toilet users in Scotland, in comparison with over 800,000 disabled people. The cost impact of making CP toilets mandatory per CP toilet user is therefore much greater than for accessible toilets and their users.

A number of items are provided for further consideration as a result of the research, these are as follows:

• In order to make a significant difference to CP toilet provision in Scotland, Government intervention will be required. Initially this could be to set a minimum standard that all such facilities should meet.

• It is understood that work is underway by the UK Government to pursue a voluntary approach to achieving increased provision of Changing Places toilets. It is thought that this could be driven by stakeholders with the UK Government playing an initial role in bringing people together and helping to establish agreement on how such an approach might work in practice. Scottish Government may wish to explore the opportunities that arise from a UK approach.

• Eventually intervention may be via provision through building standards or perhaps alternative legislative measures. Building standards would give a push for new construction mainly, but would not adequately address the distribution of such facilities or the provision in existing buildings. Therefore, the timescales to improved provision across Scotland would be less if their provision is mandated solely through ‘purpose made’ legislation.

• The range of non-domestic buildings that would be appropriate for the inclusion of CP toilets should be given further consideration prior to determining whether or not building standards provision should be amended.

• Any changes to building standards or other legislation for CP toilets would need to consider the issue of provision of both accessible and CP toilets. Issues such as the overall size of the building, potential adverse effects of anti-social behaviour and the provision of appropriate and clear guidance would also be necessary to support any changes to legislation and regulation.

2

Introduction

BRE have been commissioned by the Building Standards Division (BSD) of the Built Environment Directorate, Scottish Government to undertake a research project to inform on the requirements and installation criteria for Changing Places (CP) toilets in non-domestic buildings.

A CP toilet facility is a larger, combined toilet and changing facility which addresses the needs of people for whom standard accessible toilet accommodation is inadequate or impractical to use. Standard 3.12 (Non-Domestic) of the Scottish Building Standards Technical Handbook requires every building to be designed and constructed in such a way that sanitary facilities are provided for all occupants of and visitors to the building. Facilities should be provided in a form that allows convenience of use and without posing a threat to the user’s health and safety.

The Technical Handbook includes guidance on the following:

• the number and type of sanitary facilities that should be provided within the building for staff and in certain premises, visitors to the building;

• general design criteria that sanitary facilities should meet; and

• general design criteria that accessible sanitary facilities should meet. (Accessible sanitary facilities are provided for use primarily by a wheelchair user).

The design criteria provided within the Technical Handbooks for accessible sanitary accommodation identifies key elements that will allow the facilities to be convenient and safe to use by most wheelchair users with or without assistance.

The provision of CP toilets is not detailed within guidance in the current building standards. However, they are promoted as ‘good practice’ within the introduction to standard 3.12 of the Non-Domestic Technical Handbook. CP toilets provide a spacious and safe environment that normally includes: a height adjustable adult-sized changing bench; a centrally placed toilet with space either side for assistance from carers; and a tracking hoist system to enable assisted use of sanitary facilities. Showering facilities are also often provided.

The requirements for CP toilets are set out within Clause 12.7 of BS8300. Standards are also provided on the Changing Places website. The requirements from both sources are more generous with regards to the size of the sanitary facilities in non-domestic properties than those identified as the minimum stated in the Technical Handbooks for accessible toilets. As a result it is likely that such facilities will only currently be installed when the client or building owner has a particular reason to provide them.

There are, however, a number of campaigns being undertaken across the UK to introduce CP toilets into cities and towns. As a result there has been an increase in the number of facilities and the type of buildings that provide them.

This report gives details of the findings of the research. The three main work items in the project were as follows:

• The CP landscape in Scotland; a review of the current provision of CP toilets and a survey of the owners and/or mangers of such facilities.

• Determination of the criteria of CP toilets; the first part of this looked at the general requirements of the facilities and the second part looks at how far the CP toilets in Scotland meet the requirements.

• A cost-benefit analysis of CP toilets, to provide evidence on the impact that introducing CP toilets into legislation will have.

3

Landscape of Changing Places Toilets

A review of the current Changing Places toilets in Scotland was carried out in the research and a database compiled of current facilities, see Appendix 3.1.

U

Sources of information

A number of sources of information on CP toilets are available and have been reviewed to determine design information and identify the location of current facilities.

Changing Places Toilets website

To identify the current provision of CP toilets in Scotland, the Changing Places consortium website (HUwww.changing-places.orgUH) was used. The website is cited as a

reference in the Non-Domestic Building Standards Technical Handbook. The website has an online search facility to locate CP toilets across the UK and provides a list of 58 within Scotland with a further seven facilities planned (Changing Places, 2009).

The Changing Places Consortium campaigns on behalf of people who cannot use standard accessible toilets. This includes people with profound and multiple learning disabilities and their carers. They need Changing Places toilets with enough space and the right equipment, including a height adjustable changing bench and a hoist. The Changing Places Consortium is campaigning for Changing Places toilets to be installed in big public places.

The members of the Consortium are as follows:

• The Centre for Accessible Environment

• PAMIS

• Mencap

• Nottingham City Council

• Dumfries and Galloway Council

• Value People Support Team

• Scottish Government

PAMIS

PAMIS was established in 1992 to provide support for people with profound and multiple learning disabilities (PMLD), their family and paid carers. PAMIS is a voluntary body with a Board of Directors.

They initially started a campaign for standard accessible toilets to be made fully accessible (PAMIS, 2010) and are now part of the Changing Places consortium (Changing Places, 2009a). PAMIS have produced a brochure that gives details of 62 CP toilets in Scotland. This list includes 15 facilities that were not on the CP toilets consortium website. The reasons for the difference in numbers between the lists were indicated by the parties to be as follows:

• The PAMIS Directory includes some facilities that do not fully comply with the CP consortium requirements, however PAMIS considered that some families would still want to use them.

• There are discrepancies due to the resources required to update the three web sites and directories when new facilities are available. Therefore, the pace of updating has varied amongst the three sources.

Learning Disability Alliance Scotland

Learning Disability Alliance Scotland (LDAS) was set up to monitor and respond to the work of the Scottish Parliament on issues related to learning disability. A total of 61 CP toilet facilities had been identified by LDAS including two which had not been included on the other lists (LDAS).

Summary

Further information, sent by PAMIS, has highlighted that the Harry Smith Complex in Lanark comprises a leisure centre and a community centre in the same building. Both facilities have a CP toilet, which was previously unknown.

Fife Council has indicated that there are 20 existing or planned facilities plus seven others (three schools and four day care centres) which are planned, but for which the location has not yet been decided. Of the 20 locations, six existing facilities were included in the above lists and five were known to be planned on the Changing Places Consortium website. This means a further one complete facility and eight planned facilities. The seven unknown locations have not been included in the total but it is worth noting that they are under consideration.

All further searches for more potential CP locations linked back to the Changing Places consortium or PAMIS websites. Combining the figures from all above sources gives a total of 77 existing CP toilets with a further 14 planned, see Appendix 3.1.

Survey of changing places toilets

A survey was developed and sent to the identified locations to confirm that they all had CP toilets and to determine their alignment with relevant standards such as BS8300.

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Survey questionnaire and methodology

The survey was agreed with Building Standards Division before being circulated to a contact for each of the locations. Where no specific contact was known, the survey was sent to an organisation email address or to the relevant local authority. As well as confirming the location, acquiring a named contact was seen as beneficial if any follow on questions were necessary.

The survey questions related to the reasons for installing the CP toilet, the cost and financing mechanism, and the frequency of use and access controls. A list of equipment and fittings was also given, with respondents to check off those provided. A copy of the questionnaire is included in Appendix 3.2.

The 91 CP toilets (77 existing and 14 planned) found within the publicly available information sources were used as the basis of the questionnaire circulation.

The survey was compiled using surveymonkey.com which compiles a respondent list and collects and displays all responses.

Reminders were sent out to respondents to obtain as near to the response target as possible.

U

Survey findings

Twenty-three responses were received to the survey. This gave a 30% response rate which is lower than the original 50% target. In undertaking follow up phone calls it was clear that the lower response rate was at least in part the result of the contact having moved on to another post within their organisation. A mix of businesses responded to the survey; see Figure 3-1 and Figure 3-2. Figure 3-3 is a map of the locations of the current CP toilets in Scotland.

The CP toilets are mostly located in towns and cities in the central belt and on the east coast of Scotland. However, there are a few in the north and one on each of Shetland, Orkney and the Isle of Skye. The majority are located in Sports Centres and Local Resource Support Centres. Other locations include shopping facilities, hospitals, educational establishments and other leisure and entertainment centres (theatres, country parks and a church). There is also a CP toilet at the Scottish Parliament.

Table 3-1 shows that only three CP toilets were installed prior to 2000. The numbers increased to 2008/2009, but new installations have fallen since then. There were only 22 responses to this question as one of the survey respondents did not answer this question.

Year of opening No.

1996 1 1998 1 1999 1 2002 2 2003 1 2006 2 2007 2 2008 4 2009 4 2010 1 2011 2 2012 1

Figure 3-1: Graph showing the Nature of Business of all known CP toilet locations

Figure 3-3: Location of CP toilets by respondents (see below for Central Scotland area)

The main reasons for installing CP toilets are given in Table 3-2. Additionally, a retail centre acted on the requests of their customers, and two resource centres made improvements to meet the needs of their service users. The CP toilet in Wishaw Public Library was installed to meet North Lanarkshire Council’s commitment to support people with disabilities access their local facilities and ensure they have appropriate resources to meet their needs. Two respondents cited both legal responsibilities and new build as reasons for installing their CP toilet, but one respondent did not give an answer for this question.

Reason No. Campaign/Pressure 0 Legal 3 New Build 14 Other 7

Table 3-2: Reasons for installation

PAMIS installed one at their offices in Dundee to be used initially as an example. However they also have disabled volunteers who use the facility. Following a presentation from PAMIS at the NHS Grampian Disability Discrimination Act Review Group, CP toilets were installed in two NHS Grampian hospitals.

A comparison of the results from this question and the previous one highlights a possible misunderstanding by respondents. Table 3-3 shows that only nine respondents claimed their CP toilet installation was ‘new build’ but in the previous question 14 respondents claimed the reason for the installation was a new build project. The confusion reflects that respondents considered refurbishment as new build in some cases.

Project type No.

New Build 9 Refurbishment 14

Table 3-3: Project types

As can be seen from Table 3-4 the costs of CP toilets varied widely. The cheapest installation costing £1,000 was at the PAMIS offices in Dundee. However they received a changing bench and hoist free of charge in return for the good marketing value for the company. The University of Dundee (where PAMIS is located) paid for the work involved in preparation of the room and PAMIS paid for a number of small items. In contrast the most expensive installation, over £40,000, was in the Esplanade Public Toilet Lerwick, Shetland Islands, but this included full construction costs. Many organisations did not know the cost, or did not have the details available when completing the questionnaire. Half of respondents answered this question.

Cost (£) No. 0-4,999 2 5,000-9,999 2 10,000-19,999 1 20,000-29,999 3 30,000-39,999 2 40,000+ 1

Table 3-4: Cost of CP toilets

Many facilities were part funded from more than one source, so the figures in Table 3-5 add up to more than the total number of respondents. Other sources of finance and support mechanisms included NHS Grampian, Local Authority capital spend programme, Public-Private Partnerships, trusts, individual donors and the Scottish Parliamentary Corporate Body’s budget.

Finance mechanism No.

Grant 3 LA 12 Private 5 Other 6

Table 3-5: Finance mechanisms

As can be seen from Tables 3-6 and 3-7, all 23 respondents have benches, hoists and large sanitary bins in their CP toilets. Almost all had a non-slip floor and an emergency alarm. Fewer had the other required equipment and detailing identified in BS8300. Table 3-6 also shows that none of the responding locations have all the equipment set out in the questionnaire.

There were two locations with nearly all the equipment requirements. The CP toilet at the Summerlee Museum of Scottish Industrial Life was fully equipped, except for a shower and the CP toilet at the Harry Smith Complex had all the equipment except for a height adjustable wash hand basin. As detailed in Section 4 of this report the criteria for CP toilets varies depending on whether information is taken from the British Standard, BS8300, from the Changing Places consortium, PAMIS or LDAS. The Esplanade public toilets in Lerwick also provides coat hooks, mirrors and shelving, and the Towerview Community Day Care Centre hold a variety of slings, with wipes and foam for cleaning, in lieu of paper roll for covering the bench.

Respondents were asked to specify the type of bench and hoist provided and these results are given in Table 3-8.

Table 3-6: Equipment included in CP toilets Organisation _{An a} dult s ize d , he ig ht a d ju s ta b le be nc h (wa ll mou n te d or fre e s ta nding) A ceilin g trackin g o r mob ile h o ist A pe nins ula r ( c e n tra lly pla c e d ) toile t A p rivacy s c reen o r cu rtain A la rge bin f o r pa ds An emerg e n c y alarm Wide tear-off paper roll A non-s li p f lo o r Ad eq u a te sp a ce (i.e. 12 met res sq u a re [3mx4m]) Heig h t ad ju stab le wash b asin Showe r

Aberdeen Royal Infirmary _{√ √ √ √ √ √ √}

Aqualibrium _{√ √ √ √ √ √ √}

Braehead Assisted Changing Room

(Braehead Shopping Centre) √ √ √ √ √ √ √ √

Burnie Day Centre _{√ √ √ √ √ √ √ √ √}

Camperdown Park _{√ √ √ √ √ √ √ √}

Capability Scotland - Head Office _{√ √ √ √ √ √ √}

Carnegie Leisure Centre _{√ √ √ √ √ √ √ √}

Drumbrae Leisure Centre _{√ √ √ √ √ √ √}

Harry Smith Complex (South

Lanarkshire Lifestyles) √ √ √ √ √ √ √ √ √ √

IKEA Edinburgh _{√ √ √ √ √ √ √ √}

Kirkwall Travel Centre _{√ √ √ √ √ √ √ √ √}

Lanark Lifestyles _{√ √ √ √ √ √ √ √ √}

Munches Street Public Toilets _{√ √ √ √ √ √}

PAMIS _{√ √ √ √ √ √ √ √ √}

Riverbank Resource Centre _{√ √ √ √ √ √ √}

Shetland Public Toilets _{√ √ √ √ √ √ √ √}

Summerlee Museum of Scottish

Industrial Life √ √ √ √ √ √ √ √ √ √

The Fingal Centre _{√ √ √ √ √ √ √ √}

The Scottish Parliament _{√ √ √ √ √ √ √ √}

Touch Base _{√ √ √ √ √ √ √ √}

Towerview Community Day Centre _{√ √ √ √ √}

Wishaw Public Library _{√ √ √ √ √ √ √}

Facility No.

Bench 23 Hoist 23 Peninsular toilet 14

Privacy screen 10

Large sanitary bin 23

Emergency Alarm 20 Paper roll 10 Non-slip floor 22 12m2 18 Height-adjustable washbasin 3 Shower 8

Table 3-7: Total numbers of equipment

Bench type No. Hoist type No.

Wall mounted 9 Ceiling 12 Free standing 6 Mobile 2 Shower bed 2 Unknown 9 Unknown 6

Table 3-8: Bench and Hoist types

Frequency of use varies widely, as can be seen from Table 3-9. Some facilities are not often used, only once or twice a month, whereas some are used many times a day. The most frequently used CP toilet is used 30 times per day at The Harry Smith Complex, South Lanarkshire. CP toilets in resource centres or day centres were the most frequently used, all used more than three times per day. Those less frequently used were in the Scottish Parliament, offices and public toilets.

Access methods for CP toilets are mixed, and four locations cited more than one way to access the CP toilet, see Table 3-10. The most common method was open access plus another form of controlled access with almost as many using the RADAR key system. Frequently a member of staff or the facility manager will allow access for anyone wishing to use the toilet.

Only one location operated a membership scheme (Braehead Shopping Centre) but this was in addition to access via staff members. Another site had a list of identified users for their CP toilet (Harry Smith Complex) but this facility also had a touch sensitive control panel providing open access to service users. A further location noted their access method as an accessible locking system. The two NHS Grampian hospital locations had open access but a RADAR key was needed to access the hoist which is kept in a cupboard.

Frequency No. 11+ per day 2 6-10 per day 3 3-5 per day 5 1-2 per day 5 1-5 per week 1 1-5 per month 2

Table 3-9: Frequency of use

Access method No.

Open access 8

Manager/staff member 10

RADAR key 6

Membership 1 Limited identified users 1

Table 3-10: Access method

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Follow up to the survey

The aim of the CP toilets consortium is to encourage use solely by those users who actually require such a facility. As such they contest that CP toilets should therefore be in addition to standard toilets and accessible toilets in non-domestic buildings. The potential for disabled people generally to safely use a CP toilet was one of the key research questions set by Building Standards Division. As a result BRE undertook follow up discussions with PAMIS, facility managers of several CP toilets, and experts from the British Standards Insitution committee for BS8300, the Access Association and members of the National Register of Access Consultants in order to determine current thinking on this issue. Some of the follow up discussions were undertaken by meetings and phone calls, otherwise email was used. Appendix 3.2 sets out findings of the follow up survey from 15 respondents.

Three questions were posed, as set out in Appendix 3.2. The responses were collated and these are given as a series of points in the appendix.

The main issue identified within BS8300 is that wheelchair accessible toilet users prefer to have a wall nearer to one side of the WC rather than it being located centrally along a wall. In this case the user has the feeling that they could fall between the peninsular WC and the wall. In this respect BS8300 states the following:

“A peninsular WC layout is only appropriate when an assistant is available,

because drop-down support rails are not considered to give sufficient support for independent transfer and it is not possible to rinse hands when seated on the WC. Furthermore, the absence of a side wall can give rise to feelings of

insecurity.”

The follow up discussions also considered the use of publicly accessible CP toilets. The survey made it clear that many facilities are managed by RADAR keys or the staff in a building. The RADAR website states the following:

"Radar would like public toilets for disabled people to be kept unlocked and in a usable condition at all times, but even a low level of damage or lack of maintenance can make toilets unusable. In many situations providers have found it necessary to restrict entry to purpose-designed toilets in order to prevent

damage caused by wilful or casual misuse.”

Respondents indicated that substantial evidence exists and is referenced within BS8300 that CP toilets are not suitable for all disabled people, in particular independent wheelchair users. The main issues are that the peninsular toilet has two drop down grab rails rather than having a fixed rail near to a wall. The drop down rail does not give the same level of support as a fixed rail during transfer from wheelchair. There is also a risk of falling and a general loss of the feeling of safety.

Wheelchair users are not able to reach the wash basin or hand driers from the toilet seat in a CP toilet, whereas the accessible version is designed for this purpose.

It should also be noted that some wheelchair users and other disabled people appear to be able to readily use a CP toilet. Clearly this is a personal issue where some wheelchair users can comfortably use a CP toilet, whilst others find it less than convenient.

The nature of the CP toilet also clearly mitigates against a high frequency of use. For one or two carers to take a CP user to the toilet and use the washing facility could take some considerable time. Respondents have indicated that this may be inconvenient to other building users. The survey has indicated evidence for the need for both CP toilets as well as accessible toilets.

Anti-social behaviour would affect the ability of building managers to ensure that the CP toilet remains usable whilst the building is open. Anti-social behaviour that leads to misuse and vandalism by members of the public are a potential concern based upon the experience of respondents to the survey of accessible public toilets. Where dirty conditions are created by other users it would make the facility unusable by CP toilet users. There is also a risk of infection to CP toilet users if anti-social behaviour takes place. The issues raised over drug’s misuse and the presence of needles and blood would be a concern. Respondents indicated that the bench was used in a building for people to sleep on. In some cases it was necessary to use a range of measures including CCTV in order to try to avoid misuse by drugs users and others, public toilets were particularly at risk in this regard.

The responses indicated that there was substantial evidence that toilets, including accessible toilets and CP toilets, had been subject to anti-social behaviour. There are cost implications for CP toilets that are greater than standard or accessible toilets as expensive equipment such as hoists will be costly to repair or replace. As building owners are risk averse then they will take measures to avoid damage and the costs associated with repair.

One respondent indicated that there are concerns over insurance and liability issues, particularly if a user has an accident using a hoist or other item of equipment. Clients are normally risk averse and this will result in decisions to not install a CP toilet if it can be avoided.

A further respondent indicated that a post installation review would be helpful, as this would deal with the finer elements of the CP toilet. For example, a shower may be a

usable. Clearly some additional cost could result from correcting any design and construction issues.

The responses indicated that attention needs to be given to the following in the design of a CP toilet:

• Items and equipment such as coat hooks, shelves and the correct bins, failure to provide the right equipment gives difficulties.

4

Changing Places Toilets Criteria

The facilities included in CP toilets as identified from the survey responses in Section 3 are wide ranging. There are however several organisations that provide guidelines for CP facilities and requirements are given in Table 4-1.

The Building Standards Technical Handbook (Non-Domestic) outlines CP toilets as an additional provision that is not within the scope of the standard. It cites the provision as good practice in buildings visited by large numbers of members of the public, such as shopping malls and larger entertainment and assembly buildings. There is also a link to the Changing Places consortium website for more information (BSD, 2010).

BS8300 is a British Standards Code of Practice for the ‘Design of buildings and their approaches to meet the needs of disabled people’. The code of practice outlines a Changing Places Toilet facility as a ‘combined toilet, shower and changing room for use by people with complex and multiple disabilities who require the help of up to two assistants’. The equipment required by the code is outlined in Table 4-1.1

It is stated in the Code of Practice and by the Changing Places consortium that CP toilets should be installed in addition to standard accessible toilets, not to replace them. CP toilets are also not designed for use as baby changing facilities and as such the Code suggests that signage is provided to indicate the location of the nearest accessible WC and baby changing facility (BSI, 2010; Changing Places, 2009).

Changing Places facilities must be accessible to the public and where possible should be located close to other managed facilities. If a location, remote from reception or staffed points, is used, the code of practice recommends that the CP toilet is locked with access by a universal key scheme (BSI, 2010).

The survey undertaken for this research asked respondents to identify which design criteria were included. From the survey responses, none have indicated that they meet the full list of requirements as stated in the British Standard, BS8300.

Findings

The requirements from the British Standard (BS8300), Changing Places Consortium, PAMIS and the Learning Disability Alliance Scotland (LDAS) are largely similar with regards to the equipment that should be provided and the space required within the room. The British Standard does however have a longer list of fittings and accessories. The items that are detailed are given in Table 4-1 as well as a paper towel dispenser, full length mirror, waste disposal bin, manually-operated hand dryer, sanitary towel dispenser and two clothes hooks (at 1.05m and 1.4m off the floor). BS8300 also sets requirements for heating, extraction fan noise limits and illuminance level. LDAS has additional features which include security, hygiene and signage (LDAS).

Table 4-1: Changing Places Toilets Requirements BS8300 Changing Places Con-sortium PAMIS LDAS

A height adjustable, adult sized changing bench (minimum length of 1.8m) The bench can be either free-standing or wall mounted

√ √ √ √

A tracking hoist system, or mobile hoist (providing access to the toilet, washbasin, changing bench and open space to transfer)

√ √ √ √

A peninsular toilet (with space either side for

carers and drop down support rails) √ √ √ √

A dignity (privacy)screen/curtain √ √ √ √

Wide tear off paper roll to cover the bench √ √ √

A large sanitary bin for disposable pads √ √ √ √

A non-slip floor √ √ √

A hydraulic/manual or power-operated height-adjustable washbasin

√ √*

A shower/floor drain √ √*

EQUIPMENT

An emergency alarm √ √ √

Adequate space in the changing area for the

disabled person and up to two carers (12m2 i.e.

3mx4m)

√ √ √ √

SPACE

Ceiling height of at least 2.4m √

Toilet is locked on arrival (with a Radar key or

the key available from information desk etc) √

SECURITY Toilet has an attendant √

Clean √

HYGIENE

Well-maintained √

SIGNAGE

Clear signs and symbols are used on the facility √

*(CP Consortium: a height-adjustable washbasin is only required to be considered by the CP Consortium but is required in the BS. A shower should be provided for relevant types of managed buildings such as leisure centres, travel hubs or for specific projects. A shower is not required for all Changing Places toilets.)

5

Cost Benefit

To undertake the cost-benefit of CP toilets it was intended to use a number of actual examples in different building types. However, although the research did seek costing information from owners, this was typically given as approximate estimates of the total cost for the building. As many of the facilities have been built within existing buildings to date; the costs may not transfer readily to new build CP toilets.

For the above reasons it was decided to use costs identified through contacts with contractors and through published data on different types of buildings. Five different building types were identified and were used as the basis of the costings to include both initial capital costs and those involved over a 60 year life of the building.

Benefits were considered from the point of view of the number of potential CP toilet users as the main issue. However, further benefits were considered from the perspectives of social, economic and environmental issues. The only tangible aspect of the benefits is the number of users and therefore a straight relationship between the cost of a CP toilet over 60 years (stated by cost per year) and the number of users has been estimated. A further estimate of the number of new buildings each year that might install a CP toilet has been taken in order to give a scaled up figure for Scotland.

As for all cost-benefit work there are a number of assumptions and estimates that needed to be made. These issues are considered below.

Number of Changing Places Toilets users

The number of people who would benefit from the use of CP toilets in Scotland has been estimated from previously published research. The Changing Places website states the following:

“Thousands of people need the Changing Places toilets that would help them to

enjoy the day to day activities many of us take for granted.”

This includes people with profound and multiple learning disabilities and their carers, as well as many other disabled people. Standard accessible toilets do not provide changing benches or hoists that are necessary in CP toilets and most are too small to accommodate more than one person. Changing Places states that whilst government policy promotes the idea of ‘community participation’ and ‘active citizenship’, for some people with disabilities the lack of a fully accessible toilet is denying them this right. A study was undertaken specifically on the potential user community for CP toilets by Professor James Hogg of the University of Dundee (Hogg, 2009). The study was commissioned by organisations that promote CP toilets, such as the Changing Places consortium. The objectives of the study were to provide an estimate of the potential numbers of users. The study was however undertaken on a UK basis and did not separately identify Scotland. In this respect the numbers may be skewed by specific factors in different parts of the UK. For example, it is known that certain aspects of ill health and disability are higher in Scotland than other parts of the UK, with greater incidence of heart and stroke problems. The report does however identify areas where Scotland may be less affected by disability, for example where ethnic groups with

The Hogg report indicates that it is apparent that those with profound intellectual and multiple disabilities and their carers are not alone in requiring support with respect to activities of daily living relevant to toilet use. Therefore, to derive such estimates a wide range of databases were explored, including national and international governmental and health agency statistics, websites of voluntary organisations and literature searches of a wide range of electronic research databases. Where the report draws on such material this is cited in footnotes. The quality and scope of the information available was highly variable. Some estimates could be made with confidence; in others the best that could be offered was an informed guess.

The groups considered included people with intellectual disabilities, those with physical disabilities and older people. These groups have been further subdivided and the estimates for the subgroups are presented in the report. The numbers of potential users of CP toilets has been estimated by Hogg and this data is set out in Table 5-1, where the various categories are subdivided.

It is clear that in some sub-categories that there are precise numbers given, whilst in others the numbers are rounded to the nearest 500. This reflects the confidence in the sources from which the data was derived. Overall the total estimate was 223,798 – 230,252. Hogg states that an estimate of 250,000 would not be unreasonable for the whole of the UK.

The 2010 annual mid-year population estimate for the UK was 62,262,000, an increase of 470,000 over the previous year (Office for National Statistics, 2010). The split of UK population for mid 2010 is set out in Table 5-2. The data shows that Scotland has a population of 5,222,000, which is 8.39% of the total UK.

If an estimate of 250,000 potential users is taken for the UK as a whole, then a straight estimate for Scotland based on 8.39% is 20,975. If the range given by Hogg is used then the estimated range for Scotland would be 18,777 to 19,318. An overall estimate of 20,000 users may be considered reasonable to cover Scotland in the absence of other indicators to suggest that the potential user base is greater than elsewhere in the UK.

The overall number of disabled people in the UK has been estimated by various sources, these are summarised by the Disabled Living Foundation website key facts (DLF, 2012). It is stated that there are 10,000,000 disabled people, of whom 5,000,000 are over the state pension age. DLF states that there are 770,000 disabled children under the age of 16 years in the UK, which are assumed to be part of the overall 10,000,000 figure.

If the same population split (Table 5-2) is used to estimate the overall numbers of disabled people in Scotland, then the following is found:

• Total number of disabled people – 835,520, or 16% of the total population.

• Total number of elderly and disabled – 419,500, or 8% of the total population.

Condition Sub-category Estimated number of CP toilet users – sub-categories

Estimated number of CP toilet users

Intellectual disability (none) 30,328 – 36,782

Physical disability Cerebral palsy

Spina Bifida

Motor Neurone Disease Parkinson disease Multiple sclerosis Stroke/heart failure Arthritis

Traumatic brain injury

30,947 8,000 500 * 8,500 * * 13,437 61,384

Older people Nursing and residential

homes

Older people in private accommodation

116,695

15,391 132,086

Total 223,798 – 230,252

Table 5-1: Potential CP Toilets user numbers in the UK (after Hogg, 2009)

Country Mid-2010 population

(thousands) % of population United Kingdom 62,262 100% Scotland 5,222 8.39% England 52,234 83.89% Wales 3,006 4.83% Northern Ireland 1,799 2.89%

If it is assumed that the total number of disabled people is in fact 839,000 or 16% of the population then it can be assumed that this is the maximum number who would make use of facilities such as accessible toilets in non-domestic buildings. It can be further assumed that all those people requiring use of Changing Places toilets are included in the figure of 839,000 disabled people. Therefore, those people requiring use of CP toilets make up 2.38% of disabled people and 0.38% of the total population of Scotland (or 1 in 380).

In addition to the resident population other potential users would include those on business or holiday. The numbers of disabled people overall will be relatively high, but the number requiring CP toilets is likely to be relatively low. However, there is no data on the movement from other countries of the latter group.

Cost - Benefit

The cost – benefit analysis prepared for this report appears to be the first to be undertaken for CP toilets. There are a number of assumptions and uncertainties that need to be addressed, as well as determining the costs and benefits. Applying a monetary measure to the benefits is difficult as they mainly apply to individual users and their carers. However, benefits can be realised in terms of social or health impacts as well as monetary.

Assumptions and uncertainties

The preparation of any cost – benefit analysis is subject to some uncertainties and assumptions. For the current research the assumptions are as follows:

• The CP toilets apply only to provision within certain non-domestic buildings; no domestic buildings are likely to contain them. The range of buildings involved include transport buildings (major railway stations and airports), motorway services, sport and leisure facilities, cultural buildings (museums, concert halls, art galleries), stadia and auditoria, shopping centres, key public buildings, educational buildings and health facilities. Offices, individual shops, factories, warehouses, data centres, call centres, workshops and similar are unlikely to be included within the requirements for CP toilets, unless they provide a specific service to CP toilet users.

• The description of CP toilets as given in BS8300 is the basis of the specification used to build up the costs for the facilities.

• The numbers of people who could directly benefit from the use of CP toilets is as set out in the above section of this report.

• CP toilets should be in addition to the provision of accessible toilets within the building types described above. However, no more than one CP toilet would be required within any building.

• Replacement periods for the equipment used in a CP toilet should be assumed based upon their likely lifetime. However, at least two major refurbishment points within a building lifetime of 60 years are to be expected. These would require replacement of all equipment, including items such as hoists.

• A maintenance regime is assumed to be necessary for CP toilets. This would involve service to the mechanical components such as hoists and hand dryers. A flat sum for annual maintenance has been assumed. Maintenance also includes a requirement for daily cleaning of the facilities. It is assumed that operation of each of the facilities is around 350 days per year.

The uncertainties are as follows:

• The total number of non-domestic buildings within the categories set out in the assumptions that are built each year is uncertain. Those buildings would represent only a certain percentage of non-domestic building warrants each year. The estimated number of relevant building warrants for non-domestic buildings is 1,000 per annum. The Optimal Report (2011) into the appointment of Verifiers indicated that there were over 40,000 building warrants granted in 2009/10 by local authorities. Estimates of around 2,000,000 homes and 200,000 non-domestic buildings have been used by others in determining numbers of the building stock in the country. If it is then assumed that 10% of building warrants are non-domestic, then 4,000 of the warrants in 2009/10 would be relevant. An estimate of 25% or 1,000 non-domestic buildings may be in the category to benefit from a CP toilet. The types of buildings might include any public building, retail developments, travel buildings (railways, airports, bus stations, etc), sports centres, larger restaurants, schools, hospitals and entertainment buildings. Therefore, this estimate is used for cost – benefit purposes.

• The specification of CP toilets as recommended by other groups may change over time with a resulting change in the technical standards.

• The estimates of potential CP toilet users may not be accurate. To date only one study has been completed and it relies on a range of data sources each with a different basis of estimation. The study does not consider the number of people who may never leave their own place of residence, whether or not facilities are made available.

• The lifetime of the equipment used in CP toilets is highly variable, but in most cases will be less than the 60 year design life of a building. Regular replacement of some components is an uncertainly, especially where the equipment is not fixed.

Sectors and groups affected

Building standards related to the provision of access and facilities that assist disabled people have been in existence for around 20 years. The provisions that were brought into building standards in 2007 represent a high standard and for non-domestic buildings provide for many of the aspects covered by BS8300.

The change in provision has benefited a wide range of disabled people, which is a benefit with regard to employment opportunities, leisure and self-sufficiency with regards to shopping and access to services. There are many more disabled people than the more limited group who have been estimated to benefit from CP toilets, the above section estimated 20,000 as being resident in Scotland. This group and their carers are the primary group benefiting from the provision of CP toilets. Carers may be family members or those who are employed by the private or public sector to care for severely disabled people.

There are other groups and sectors who are affected by the general provision of CP toilets and especially where they might become mandatory under building standards. Table 5-3 provides a summary of the groups and sectors and the positive and negative impacts.

Sector / Group Impact – negative cost Impact – positive cost

Construction - designers Need for training and application

of knowledge to design of CP toilets

Opportunities for early adopters of knowledge, offer greater service to client

Construction – main contractors Need for training and application

of knowledge to construction of CP toilets

--- Construction – specialist CP

toilet contractors Need for training and application of knowledge to construction of CP toilets

Opportunities for new business, related to new build construction and also associated benefit for increase demand for retrofitting existing buildings

Maintenance contract for hoists, benches, etc

Construction – suppliers, manufacturers

Development of new products specifically for CP toilets

Increased business, especially for hoists, benches and shower units

Developers / owners Increased construction costs,

either in addition to accessible toilets or in place of the accessible toilet Increased cleaning and maintenance costs

Increased business for building occupiers by allowing access to a greater range of people and their carers

Building Standards Increased amount of design

checking and site assessment of the installation (Reasonable Inquiry), within existing fee structure.

Higher building warrant fees would be payable due to the additional building costs for a building with a CP toilet.

Table 5-3: Sectors and groups affected by CP toilet provision within building standards

Breakdown of costs and benefits

The costs and benefits of CP toilets can be broadly categorised into three groups; economic, social and environmental. Although it is difficult to assign a monetary value to the benefit the facility would provide the number of people who could potentially benefit against the costs involved are included.

It is necessary to recognise the uncertainty attached to the cost and benefit variables. For example, relative costs may shift as familiarity with new designs and techniques increase and through scale of economies. At present the cost of a CP toilet is largely an unknown quantity for new build situations, as most have been retrofitted. Table 5-4 shows four examples of CP toilets against the criteria set out within the CP toilets guidance contained in BS8300. It is clear however that these examples do not always meet the full range of criteria. The CP toilet may be restricted in total size, restricted in one dimension, or for example may not have two clothes hooks.

CP Toilet Item BS8300 Ex 1 Ex 2 Ex 3 Ex 4 Ex 5 Type Item NA Demons tration Country Park Retail Shop’g Centre Public toilet

Paper towel dispenser Yes Yes Yes Yes Yes No

Full length mirror Yes Yes Part

length Yes Yes No

Sanitary disposal bin Yes Yes No Yes Yes Yes

Alarm reset button Yes Yes Yes Yes No Yes

Full room tracked hoist Yes Yes Yes Yes Yes Yes

Vertical grab rail x 2 Yes Yes Yes Yes Yes Yes

X 3

Drop down rails x 2 Yes Yes Yes Yes Yes Yes

Flat topped cistern Yes Yes Yes Yes Yes Yes

Peninsular WC Yes Yes Yes No Yes Yes

Power assist wash basin Yes Yes Yes Yes Yes No

Waste disposal bin Yes Yes Yes Yes Yes Yes

Manually operated hand dryer

Yes Yes Yes Yes Yes Yes

privacy screen Yes Yes Yes Yes No No

Alarm pull cord Yes Yes Yes Yes No Yes

Changing bench Yes Yes Yes Yes Yes Yes

Floor drain Yes Yes Yes No No No

Shower unit Yes Yes Yes No No No

Wide paper roll

dispenser Yes Yes Yes No Yes No

Sanitary towel dispenser Yes Yes Yes Yes Yes Yes

Two clothes hooks Yes Yes Yes Yes Yes One

12 m2 (4 x 3 m) Yes Yes No 2.5 x 5.5 = 13.75 m2 Yes Yes No 2.5 x 3 = 7.5 m2

2.4 m height Yes Yes Yes Yes Yes Yes

Door - 1000 mm wide clear

Yes Yes Yes N/A N/A Yes

Lockable door - RADAR Yes Not

relevant Yes Yes No Yes

clear signage Yes Not

relevant No Yes Yes Yes

well maintained Yes Not

relevant Yes Yes Yes Yes

Table 5-4: CP Toilet examples – items included (N/A – information not available)

The cost-benefit model was set up in a spreadsheet showing annual costs over a 60 year timeframe. The costs included the following:

• Capital costs of equipment and construction

• Costs of major refurbishment at 20 year interval (estimated to be half of initial construction costs), plus replacement of all items at this time.

• Maintenance costs – service to mechanical equipment and cleaning (daily and deep cleaning)

• Consumables – toilet rolls, large towel rolls and soaps.

Tables 5-5a-d provide key data from the cost – benefit spreadsheet. Table 5-5a shows the estimated construction costs (capital) related to a new CP toilet within the five types of buildings. In order to build up the costs the complete set of equipment as specified in BS8300 has been included in all buildings. The costs for the equipment include supply and installation, using data provided by contractors.

The main variable in cost is per square metre of floor. These construction costs are based on industry data for different building types in Scotland as follows:

• general office - £900 m2

• leisure (dry sports) - £1,250 m2

• shopping centre - £2,500 m2

• educational (special needs school) - £1,650 m2

• health (general hospital) - £1,980 m2.

The construction costs are based upon those for walls, floors, ceilings, surface finishes and services. Costs towards the higher end of industry figures for the types of buildings concerned have been used. One area of significance for CP toilets is the cost related to surface finishes, including the walls, floors and ceilings. The ability to clean these effectively and to control germs and infections has been identified as a serious issue. The example CP toilets given in Table 5-4 typically have painted finishes either onto plaster or directly to masonry as the use of wet wall, tiles or synthetic finishes vary in cost. The cost-benefit model built up a high specification finish which has been included within the initial construction costs, with a replacement required at 20 year intervals, a proportion (half) of the initial cost has been estimated.

Construction costs also include external drainage and plumber work related to connection of the water supply and waste pipes to the main supply and disposal services. A flat rate of £15,000 has been estimated for these activities regardless of the building type, although issues such as ground conditions will have some bearing.

The maintenance costs related to cleaning are based on cleaning costs per square metre of building and are based on those taken from the Association for Public Service Excellence (APSE). The costs include daily cleaning using standard methods and approaches. All costs for the different building types are estimated to be the same. There is also an annual cost related to a deep clean, which is based upon contractor costs. The cleaning costs assume that the CP toilet is located within a larger building and therefore the costs represent a proportion based on floor area.

Table 5-5b shows comparable costs related to an accessible toilet in accordance with the requirements of the Technical Standards. The costs for this facility are substantially the same as those for the CP toilets. The differences occur in the costs in relation to the equipment provided within the facility and different construction costs due to the smaller footprint of the accessible toilet than the CP toilet.

Table 5-5c shows the estimated capital costs for both facilities for each of the five building types. The equipment costs are the same in each building type, with a total cost of £11,810 for the CP toilet and £2,571 for the accessible toilet.

The construction costs include an estimate related to the building type concerned, plus external drainage and plumbing costs. These latter costs are included as it assumes that there are additional costs related to these types of toilets. For a CP toilet £10,000 has been estimated for drainage and £5,000 for plumbing; whilst for the accessible toilet £5,000 and £3,000 respectively have been estimated.

The main variable is the construction cost (which includes fabric, lighting, ventilation, heating and surface finishes) related to the different building types. The overall capital costs related to CP toilets ranges from £37,610 (general office) to £56,810 (shopping centre/mall), with an average of £46,682. The overall capital costs related to accessible toilets ranges from £14,927 (general office) to £22,671 (shopping centre/mall), with an average of £18,586.

Table 5-5d shows the estimated total costs related to a 60 year lifetime of CP and accessible toilets. The 60 year costs have been built up on a spreadsheet using the initial capital costs, replacement costs, maintenance costs and consumables.

The total costs associated with CP toilets have been assessed as being substantially higher than for the accessible toilets. The range for CP toilets is £418,395 (general office) to £456,795 (shopping centre/mall), with an average of £436,539. The range for accessible toilets is £112,876 (general office) to £128,364 (shopping centre/mall), with an average of £125,892. A substantial element of the cost build up is due to consumables used because the costs for CP toilets is likely to be higher due to the use of large paper towel rolls. Cleaning costs are also higher based upon the larger space for a CP toilet and the need for deep cleaning.

The average annual cost of a CP toilet for each year over a 60 year period is £7,275 and £2,098 for the accessible toilet. These costs are based upon current (at time of writing) prices of equipment, consumables, construction and maintenance. These prices will clearly be subject to inflation each year of the 60 year period.

Table 5-6 gives a summary of the benefits under the broad categories of social, economic and environment factors. The social benefits relate primarily to the potential users of CP toilets, of which a figure of 20,000 in Scotland has been estimated from the available data. The user group are the primary beneficiaries, but their carers, family members and friends are a secondary group that would benefit. Indeed the user group and the carers are in practice inseparable.

Environmental benefits relate to a reduction in the potential for the spread of infection. Inadequate toilet and changing facilities present a direct risk to users and carers, infections could be either picked up from poor facilities or allow the spread of infection from users to others. This has particular relevance in health facilities where many people will already be at risk of infection. The provision of CP toilets in buildings has potential benefit in reducing the risks related to picking up or passing on infection.

The economic benefits relate to the potential increase in business or numbers of visitors that could be achieved by businesses. For example a cinema with an appropriate CP toilet would attract users and their carers, as well as other family members and friends.

For both the environment and economic benefits it is not possible to ascribe a numerical value to the benefit. The main numeric value is therefore the number of potential users i.e. 20,000.

Cost – benefit analysis

The assumptions made for the cost-benefit estimate are as follows:

• Cost per annum of a CP toilet over 60 year lifetime: £7,275.

• Cost per annum of an accessible toilet over 60 year lifetime: £2,098.

• Number of potential users of CP toilets in Scotland, based on resident users and not additional visitors from other countries: 20,000.

• Number of potential users of accessible toilets in Scotland: 16% of Population – 835,520.

• Number of new buildings each year that might be required to use a CP toilet, as well as accessible toilets: 1,000.

• It is assumed that only one accessible toilet is present in each building, some may have two or more.

The cost-benefit estimate for CP toilets is given as follows: (£7,275 x 1,000 buildings) = £7,275,000 per 20,000 users, or

= £363.75 per CP toilet user.

For comparison purposes the cost-benefit estimate for accessible toilets is given as follows:

(£2,098 x 1,000 buildings) = £2,098,000 per 835,520 users, or = £2.50 per accessible toilet user.

CP Toilet Item Cost - £

Supply / Install

Lifetime (estimated) - years Equipment

Paper towel dispenser £20 5

Full length mirror £60 10

Sanitary disposal bin £50 5

Alarm reset button £100 10

Full room tracked hoist £3,000 10

Vertical grab rail x 2 £155 10

Drop down rails x 2 £500 5

Flat topped cistern £65 20

Peninsular WC £200 20

Power assist wash basin £1,750 10

Waste disposal bin £10 5

Manually operated hand dryer £150 5

privacy screen £120 10

Alarm pull cord £100 10

Changing bench £3,500 10

Floor drain £25 10

Shower unit £350 10

Wide paper roll dispenser £35 5

Sanitary towel dispenser £155 10

Two clothes hooks £15 10

Door £1,000 20

Security – lock (RADAR) £250 20

Signage £200 10

Drainage and plumbing – external

£15,000 20

Construction Costs £/square metre of specific

building type 20 – refurbishment costs – 50% of initial cost

Maintenance

Daily clean – annual cost – related to square metre in larger building/facility

£180 NR

Annual deep clean £100 NR

Hoist, dryer (six month service @£49/hour)

£500 NR

Toilet Consumables / annum £3,900 NR

Accessible Toilet Item Cost - £

Supply / Install

Lifetime - years Equipment

Paper towel dispenser £20 5

long mirror £60 10

Sanitary disposal bin £50 5

Alarm reset button £100 10

Drop down rails x 1 £250 5

Flat topped cistern £65 20

WC - 480 mm height £200 20

Hand rinse basin £100 20

Waste disposal bin £10 5

Manually operated hand dryer £150 5

Alarm pull cord £100 10

Sanitary towel dispenser £155 10

Clothes hook £8 10

Horizontal grab rail x 1 £78 10

Shelf £25 10

Door £1,000 20

Security – lock (RADAR) 20

Signage £200 10

Drainage and plumbing –

external £8,000 20

Construction Costs £/square metre of specific

building type

20 – refurbishment costs – 50% of initial cost

Maintenance

Daily clean – annual cost – related to square metre in larger building/facility

£180 NR

Annual deep clean £100 NR

Dryer (six month service

@£49/hour) £200 NR

Toilet Consumables / annum £900 NR

Building type

CP Toilet Accessible toilet

Equipment and items (see table 5.5a) Space construction costs U

Total costU Equipment

and items (see table 5.5b) Space construction costs U Total costU Office – standard £11,810 £25,800 U £37,610U £2,571 £12,356 U£14,927U Leisure – dry sports £11,810 £33,000 U £41,810U £2,571 £14,050 U£16,621U Retail – shopping centre £11,810 £45,000 U£56,810U £2,571 £20,100 U£22,671U Educational – special needs school £11,810 £34,800 U£46,610U £2,571 £15,986 U£18,557U Health – general hospital £11,810 £38,760 U£50,750U £2,571 £17,583 U£20,154U

Table 5-5c: CP and accessible toilets – capital costs in different buildings

Building type

CP Toilet Accessible toilet

Capital

Costs 60 year costs Total cost Capital Costs 60 year costs Total cost

Office – standard £37,610 £380,785 U £418,395U £14,927 £97,949 U£112,876U Leisure – dry sports £41,810 £384,985 U £426,795U £16,620 £98,131 U£144,751U Retail – shopping centre £56,810 £399,985 U£456,795U £22,670 £105,694 U£128,364U Educational – special needs school £46,610 £389,785 U£436,395U £18,557 £101,579 U£120,136U Health – general hospital £50,570 £393,745 U£444,315U £20,154 £103,176 U£123,330U

Category Benefit Description

Social Direct benefit to 20,000

potential users in Scotland

Better hygienic conditions for users, with reduced potential for infection from currently inadequate facilities. Improved comfort of the users.

Greater range of services to which users can access. Better provision of privacy for users in comparison with currently inadequate provisions.

An assumption that all this group are likely to use any such new facility. There will be geographic

considerations, with facilities within cities more likely to be used more regularly than less populated areas.

Social Benefit to carers of CP toilet

users Better hygienic conditions for carers, with reduced potential for infection from currently inadequate facilities. Improved comfort of the carers.

Improved range of services to which carers can assist users to access.

Environment Reduced risk of infection The users and their carers will be less likely to

experience inadequate toilets and other spaces for the use of the facility, changing and cleaning.

Economic Increased customer base The CP toilet provision will allow greater use of certain

types of buildings by users, carers, friends and family members. There are potential income benefits for the owners/operators of such facilities, in particular leisure uses, retail and public services.

Avoidance of conflicts with other legislation such as the Equality Act and the associated legal issues.