Grab rails in washrooms in public buildings, hotels and care homes

Correctly positioned grab rails give people with disabilities both stability and reassurance when using the washroom.

In public buildings, grab rails should be installed to comply with Approved Document M of the Building Regulations. Whatever sort of rail is selected compatibility with the wall it is to be fixed to is essential. Manufacturers fixing instructions should be rigidly adhered to.

Plastic grab rails and plastic-coated metal grab rails are suitable for use in washrooms. Rails are available in different lengths, diameters and wall clearance measurements. Approved Document M specifies these measurements. Some rails have a higher weight capacity but they all depend on the strength of the wall.

Safety and security are very important in enabling anyone to feel independent in the bathroom. Wall-mounted rails can be installed which fit across bath. They can be helpful to give confidence to people getting in and out of the bath and they can be folded up against the wall when not in use.

Some rails are floor mounted and adjustable in height. 

Grab rails are available in a variety of lengths and thicknesses - a chunkier rail could be easier to gip by people with limited dexterity. Some rails have a special ribbed or textured surface to give extra grip when wet. Metal rails should be electrically earthed but all-plastic rails are more straightforward to install since they don't require earth-bonding.

Straight rails are available in a variety of lengths and thicknesses - a chunkier rail can be easier to grip with limited dexterity. Some rails have a special grip-assisted surface. Brightly coloured rails will give a better visual contrast against white bathroom walls. 

Angled rails are useful when the user wants to change position from standing to sitting. 

Hinged rails can be used where a projecting fixed rail could be awkward - next to the toilet or washbasin. When the rails are not required, they can be pushed up out of the way against the wall. An additional support leg will provide extra security for heavier users.

Poles which are fitted to the floor, or from floor-to-ceiling can be useful in places where there is no convenient wall for fixing a rail. A floor-to-ceiling pole is adjustable in height, and may need no structural work to install it. As well as the vertical support, there is a horizontal bar that is adjustable in height, and may also pivot - to help with stepping in and out of the bath, for example.

Colour Contrast and Luminance Contrast 
People with visual impairments or with learning difficulties need grab rails and fittings which contrast with their surroundings. Visual contrast can be achieved by differences in colour and/or luminance. For example colour contrast can be achieved with dark blue rails against a white wall. 

Luminance is measured by Light Reflectance Value (LRV) where 0 on the LRV scale indicates black and 100 indicates white. A minimum 30-point difference in luminance on this scale should be achieved between the grab rail and its surrounds. Luminance values are given in British Standard BS 8300.

Perching stools As their name suggests perching stools assist the user to perch in a semi-standing position to get closer to washbasins. They have a sloping angled seat and are suitable for people who can take some of their weight through their legs. Because of this semi-standing position, less leg room is needed. Perching stools can usually be adjusted to the height of the user and some have armrests which help with getting up from a sitting position. Perching stools can be very helpful in maintaining independence. 

Shower chairs These are specially designed to wheel into a shower enclosure, where the user can remain seated while they wash. Some are self-propelled and some are carer-assisted models. With all shower chairs the ease of manoeuvring in a confined space is important. Wipe-clean waterproof covers are also essential. Depending on individual needs, armrests and footrests may be required. Any armrest should lift out of the way for side transfers.

Shower seats Simple shower seats may be made from slatted wood or plastic. More sophisticated designs are padded to offer more comfort and some have centre hole and horseshoe shapes to make personal hygiene easier. Wall-mounted seats are designed to foldout of the way against the wall.
Whether wall-mounted or free-standing shower seats should be sturdy enough to support the user safely. The fixings for a wall-mounted seat must be adequate, and the wall must be strong enough Legs at the front reinforce the strength of the seat. Many people need armrests to push against to help them stand up - again, these will take considerable pressure, and need to be sturdy.

Body Driers Wall-mounted electrically heated warm air body dryers can be positioned in the shower cubicle or on the wall in a shower area. They produce jets of warm air that can be used to dry. Body driers cannot dry all areas of the body from a seated position. Care must be taken with installation of these products in bathroom areas and reference to the appropriate electrical standards must be made.

Hand dryers Most hand dryers have a sensor which automatically turns the dryer on when hands are placed where the warm air is expelled. 

Water temperature indicators These products can be used with a bath or washbasin to reduce the risk of scalding. Temperature indicators show when the temperature of water in the bath or washbasin is above a safe level. Some indicators change colour, others give a digital reading of the actual water temperature, other give an audible warning. These products are particularly useful if the user has reduced skin sensation and needs an objective way to determine temperatures.

Water level indicators These products are fitted with audible or visual alarms to highlight the risk of flooding. Additionally some devices automatically empty excess water or automatically cut the flow of water to the bath or washbasin when a set water level is reached. These products can be particularly useful when someone has short-term memory problems or a visual impairment. Pull cords |These can be positioned in areas where a personal alarm button may be unsuitable. The pull cord should belong enough to be easily reached from the floor.

Toilet/bidet adaptors A spray unit can be fitted as an add-on bidet to an existing toilet. These devices provide all the features associated with a dedicated shower/bidet toilet. 

Toilet seat risers and supports Raising the height of a toilet seat can make it much easier for a less able person to use it independently. A raised seat is a cost-effective product that fits onto a standard WC in place of its own seat, raising the height from two to six inches.