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The results of the ergonomic testing and feedback from the Open Days were carefully reviewed by the design team. Some minor modifications were required to achieve the optimal layout for each design option.
The layouts below are provisional, as they are currently out for consultation as part of the revision of HBN 40 ‘Sanitary spaces’. The final layouts will be published in HBN 40 later this year.
Proposals
The layouts below illustrate options for assisted en-suite shower rooms, which are suitable for a single bedroom where privacy can be maintained.

It is acknowledged that many of the requirements for independent users are incompatible with assisted use (e.g. the fixing height of the washbasin for ambulant and semi-ambulant people). However, the primary concern within healthcare environments is to provide space and facilities for assistance and therefore certain limitations/restrictions on independent access are considered reasonable within an acute hospital setting.

Principles:
  • Single patient use with assistance is primary use.
  • Use of mobile hoist for assisted use is essential.
  • Assisted access provided by using space within adjoining bedroom.
  • Hinged door, adjacent to toilet, is generally intended for staff use only (see notes).
  • Use of ceiling hoist is optional.
  • An adjustable-height wash basin is required to meet the needs of seated and standing patients.
  • Handwipes are provided for the users to cleanse their hands prior to transferring back onto the wheelchair to avoid staining clothes or soiling the wheelchair.
  • Call reset buttons should be located adjacent to shower seat (shower controls) and toilet (on the back of the door).
  • A full wet floor is assumed.
  • No tip-up seat within the dry area of the room has been provided. It is assumed that the toilet pan or shower seat will be used instead.
Notes:
  • The door illustrated and tested is a folding/sliding door. Alternative solutions may be considered subject to meeting the requirements for easy access and operation by users/staff.
  • See Health Building Note 40 Volume 1 Part A for further details of clear width requirements for access.
  • Consideration may be given to providing an acceptable opening system for the hinged door adjacent to the toilet door that allows independent wheelchair users to part open the door to assist with transfer.
  • The sliding door may use a roller catch rather than a lever handle as indicated on the layout drawings; this would allow a longer horizontal grabrail and wider mirror to be used. Note: 500 mm wide mirror is preferred.
  • Call light indicator to be located over bedroom door in the corridor.
  • Clinical waste bin, adjacent to the toilet, should be a maximum of 200 mm wide and 480 mm high and should be capable of being operated with one hand.
  • Dispensers mounted on the back of the hinged door should not project greater than approximately 50 mm (depending on door design) so as not to conflict with the use of the hinged grabrail.
Door access
The door nearest the shower is a folding/sliding door. The door adjacent the toilet is a standard hinged door.

The folding/sliding door is designed to be released from the overhead track in the case of an emergency and to assist with mobile hoist access.

Both doors need to be open for assisted use of the facilities. The hinged door will remain closed in most circumstances involving non-assisted use. The drawing below illustrates the space required for assisted access to the toilet and the opening widths for the varying door access arrangements.

Detailed layout:
Detailed layout drawing
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linkDownload drawing
1.1Mb PDF file
Option 1a:
Assisted rectangular en-suite WC and shower room – with adjustable tip-up shower seat
Assisted use (both doors open):
Activities:
  • Ceiling hoist access to toilet and tip-up shower seat.
  • Mobile hoist access to toilet, tip-up shower seat and to collapsed patient on the floor.
  • Standing and raising aid access to toilet and tip-up shower seat.
  • Sanitary chair access to toilet.
  • Shower chair access to the shower area.
Notes:
  • Tip-up seat located away from corner of room to allow assisted showering from either side of patient.
  • The hinged grabrail should move with, or be consistently located in relation to, the tip-up shower seat.
  • Shower controls are not reachable from the tip-up shower seat.
Independent use (folding/sliding door open for access):
Activities:
  • Use of shower, toilet and wash basin
Notes:
  • Tip-up shower seat located in corner of room.
  • There will be some restrictions on the ability to position a wheelchair outside the curtain while showering and to recover the chair after showering, because the shower curtain is sized and positioned for assisted access.
  • Semi-ambulant showering with use of hinged grabrails. However, some users may feel insecure without two adjacent sidewalls.
  • The 1150 mm minimum dimension from the centre of the toilet to the front of the washbasin is smaller than the recommended 1400 mm minimum in HBN 40 (see HBN 40 ‘Sanitary spaces’, Appendix 2).
Detailed layout:
Detailed layout drawing
linkView larger image
linkDownload drawing
1.3Mb PDF file
Option 1b:
Assisted rectangular en-suite WC and shower room – with fixed tip-up shower seat
Assisted use (both doors open):
Activities:
  • Ceiling hoist access to toilet – optional.
  • Mobile sling hoist access to toilet and collapsed patient on floor.
  • Standing and raising aid access to toilet.
  • Sanitary chair access to the toilet.
  • Shower chair access to the shower area.
Notes:
  • Assisted showering with restricted staff access to patient from either side when using tip-up shower seat.
  • Ceiling hoist access to tip-up shower seat is not possible.
Independent use (folding/sliding door open for access):
Activities:
  • Use of shower, toilet and wash basin
Notes:
  • There will be some restrictions on the ability of independent wheelchair users to position their wheelchair outside the curtain while showering and to recover the chair after showering, because the shower curtain is sized and positioned for assisted access.
  • Semi-ambulant showering with use of hinged grabrail and wall mounted rail. However, some users may feel insecure without two adjacent sidewalls.
  • The 1150 mm minimum dimension from the centre of the toilet to the front of the washbasin is smaller than the recommended 1400 mm minimum in HBN 40 (see HBN 40 ‘Sanitary spaces’, Appendix 2).
Detailed layout:
Detailed layout drawing
linkView larger image
linkDownload drawing
1.2Mb PDF file
Option 2:
Assisted chamfered en-suite WC and shower room
Assisted use (both doors open):
Activities:
  • Ceiling hoist access to toilet and tip-up shower seat (to be confirmed)
  • Mobile sling hoist access to toilet, tip-up shower seat and collapsed patient on floor.
  • Standing and raising aid access to toilet and tip-up shower seat.
  • Sanitary chair access to the toilet.
  • Shower chair access to shower area.
Independent use (folding/sliding door open for access):
Activities:
  • Use of shower, toilet and wash basin
Notes:
  • Independent access to shower is limited by the fact that many users will find it difficult to adjust the water temperature/flow of the shower when seated on the tip-up shower seat or shower chair.
  • The 1150 mm minimum dimension from the centre of the toilet to the front of the washbasin is smaller than the recommended 1400 mm minimum in HBN 40 (see HBN 40 ‘Sanitary spaces’, Appendix 2).
Detailed layout:
Detailed layout drawing
linkView larger image
linkDownload drawing
1.3Mb PDF file
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