This section is concerned with bathroom safety, and the products that can make bathrooms in care environments safer for users and care assistants.
Specific areas such as shower and toilet are covered on their respective pages of the Care Home Bathroom section.
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Whatever sort of rail you select, the most important thing is the strength of the fixing. Make sure that fittings are compatible with the wall it is to be attached to, and if this is a thin partition wall, it may need a backboard on other side, to which the rail can be attached through the wall.
Metal rails may be inherently corrosion-resistant (stainless steel) or have a durable powder or nylon coating. Plastic rails are more straightforward to install in a bathroom, as unlike metal ones, 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 anywhere you want to change height (from standing to sitting, for example). So – next to the toilet; by the bath; in the shower.
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.
Anti-Scald, alarms and monitors
An instantaneous water heater (shown left), delivers warm water at a constant temperature, on demand. Simple electronics control the flow and temperature, making it extremely safe, reliable and energy efficient. The unit, which is very compact, is situated just where the water is required, avoiding any wasteful runoff of cold water, before the warm begins to flow. Anti-scald, it has a fail-safe maximum temperature between 32 – 50°.
An ever increasing range of alarms and monitors is available, to help improve bathroom safety.
Anti-scald alarms include models that sit in the bath or basin, and others with a probe which senses the water temperature. Some alerts change colour to indicate that the temperature is too high, while others have an audible alarm.
For showers, you can obtain a sensor that fits between the shower head and hose, and alarms if the water temperature is too high.
There are still too many incidents of serious injury and even death from scalding in care environments. The need to store water at a high enough temperature (+ 60°C) to combat legionella, obviously increases the potential for accidents, so it is important to implement measures such as fitting anti-scald valves to the hot water supply close to the point of delivery and using thermostatic mixer taps. Alarms are useful as a final step in the chain, but vigilance is still necessary, especially where residents may be confused or have reduced sensitivity to heat.
On the subject of filling baths and basins, you can also obtain simple alarms to help you avoid the nuisance of overflowing water.
With a large suction cup to fix it to the side of the bath or sink, the waterproof overflow alarm shown on the left has two sensors to detect the water level and a loud inbuilt alarm which sounds if the water reaches the sensors. A visual LED alarm also flashes an alert.
A very cheap solution to what could be an expensive flood!
Increasingly, care environments are being fitted with nurse call and patient monitoring systems.
Specifically for the bathroom and/or toilet, a wireless alarm system with a pull cord activater provides an effective way of summoning emergency assistance.
The transmitter (waterproof pull cord operated for safety) can be fitted next to the toilet, bath or shower as required, with the flashing and sounding alert beacon fitted where staff can hear or see it. The pull cord has an LED that lights up when it is pulled, reassuring the resident that help is on its way.
The wireless reset button is fitted close to the pull cord transmitter, so that the alarm can be cancelled when someone has attended the incident.
You can read more about nurse call and telecare communications here.
Specialist products to assist with bathing for the most dependent residents are covered on theassisted bathing page.
People who can manage more independently in the bath can benefit from some simple supports such as a bath board (right) or seat that fits across the top of the bath, and which can be combined with a bath grip (left) to help with getting in and out.
A non-slip mat in the bottom of the bath can also improve confidence and safety.
An angled grab rail (see above) fixed by the side of the bath gives a support along which the bather can slide their hand as they change position.
Tap rails should be regarded with a degree of caution: they can be helpful for maintaining balance in the bath, but are only as strong as the taps they are fitted to, so shouldn’t be depended on for support by the bather pulling themselves up out of the tub.
Those bathroom safety features that don’t seem to fit in anywhere else!
Any unevenness on the floor can be hazardous. This includes loose mats: a heavyweight bathmat that doesn’t ruck up, with a good contrast in colour between it and the main floor covering, will minimise the risk.
Bathroom doors should always open outwards, providing easier access for carers if somebody should have a fall and need help. If door handles are hard to operate, replace them with easier lever-type handles. Locks on bathroom doors are not a good idea.
Any radiators or other heaters in the bathroom should have a surface that remains cool enough not to burn someone who falls or leans against them. Radiator covers can be fitted if necessary.
Tap handles should be lever style for ease of use, or even hands-free, infra-red controls. For tight budgets, there are lever adapters which fit most standard taps.