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Care Homes White Paper

Considerations and impact of toileting aids in a care environment

Care Quality Commission Essential Standards of Quality & Safety

Department of Health Care Homes National Minimum Standards

Social Care Institute for Excellence's Dignity in Care Practice Guide 09

Equality Act 2010

Download this White Paper as a PDF


One of the main Regulatory criteria for nursing and care homes – and a basic human right – is to ensure the dignity, privacy and independence of service users, with particular regard to personal care and using the toilet.

Simultaneously, home operators have to comply with Health & Safety considerations for both residents and staff: latest statistics from the Health & Safety Executive reveal care home providers reported 11,000 work related accidents in the UK. People handling is the most common cause of injury to staff, and low falls causing five fatalities and over 150 major injuries to residents. Use of good bathroom/toilet/washroom design and appropriate toilet aids can have a significant positive impact on addressing these issues.


  • Level access reduces the risk of tripping, and makes it easier for manoeuvring of wheelchairs, shower chairs and walking frames.
  • Colour and texture help users with reduced or limited visibility navigate around more easily.
  • The white paper Design Guidance & Considerations for an Accessible Bathroom/Wetroom, gives greater details and can be found for free download here:

Toileting aids Automatic shower (wash and dry) toilets The aim of an automatic shower toilet is to provide independence and dignity in toileting. It has added benefits of improved personal hygiene, reduced risk of infection and carer involvement. It combines a toilet with integral douching and drying, eliminating the need for manual cleansing with toilet tissue.

Whether the user is disabled or not, inevitably one is cleaned better with a shower than with toilet tissue, hand:body contact is eliminated with all associated issues of cross-contamination through failure to wash hands etc... The fundamental reason for a shower toilet is to effectively wash the anal area.

Cleaning with toilet tissue requires manual, mental and physical dexterity, flexibility, and balance. Cleaning with a shower requires only the ability to sit in the right place, and trigger a mechanism.

The toilet and seat also need to be at a suitable height and angle to accommodate the transfer technique, and then ensure the user is properly and safely positioned, and sat back on the toilet, providing suppor t. It also needs to accommodate diverse shapes and weights, especially with the growing incidence of obesity.

The controls need to be easy to operate regardless of manual dexterity and strength, and upper body manoeuvrability.

Options include basic bolt-on, wall-hung and floor-mounted, and height adjustable variations. Some models can be tailored to specific requirements by the specification of appropriate accessories, such as lateral body suppor t arms.

Toilet/shower lifters

Toilet lifters are fitted over the WC, and replicate automatically the natural movement of standing and sitting. They help people with limited mobility get on and off the toilet with little or no carer assistance, keeping their feet on the floor and maintain their centre of gravity to ensure balance. Shower lifters operate on the same principle, positioning the user over a shower seat.


A ceiling track hoist allows carers to transfer clients from one location to another within the room easily, with minimal weight transfer/loading and with improved safety for both.


A height adjustable washbasin enables both ambulant and wheelchair-bound residents to use the same basin safely and comfortably without unnecessary bending or stretching.

Changing bench

Wall-hung and mobile height adjustable changing bench allows users to lie down when being showered or changed. A front rail slides away when not in use, facilitating transfer, yet ensures the client is safe when on the bench, whilst still allowing access for the carer.

Shower seats

A wall-mounted, height adjustable shower seat gives clients a safer, more comfortable showering experience, with the flexibility of folding away against the wall when not in use.

Body driers

For clients with sensitive skin or skin ailments, the Apres body drier blows warm air at an average 70°F (20°C) to dr y the whole body thoroughly without any rubbing. Total Hygiene maintains that when installed in an enclosed space, the running costs are comparable with laundering towels.


Height adjustable baths enhance safety for clients and carers reducing strain on the carer's back while bending to help the client bathe, and making it easier for the client to get in and out without having to wait for the bath to fill or empty.

Case studies

Glenashling Nursing Home

The establishment installed a Closomat wash & dry toilet and Aerolet toilet lift in its new extension as a trial. It has now installed a further three.

Manager Garry Gavigan executed a cost analysis on the investment, which showed:

  • cost of care assistance to toilet: 2 staff required per time, 15 minutes/ time, five times a day = £7117.5/client, or £213525 for 30 clients
  • cost of installing a Clos-o-Mat £2500, with similar for an Aerolet

Therefore, even if one carer still needed to accompany the client, toileting costs are almost halved if both pieces of equipment provided.

If carer assistance is eliminated completely for some residents, or just a Closomat or Aerolet installed, savings yield a 50+% reduction in staff costs.

Garry says, “It’s much more than just the financial element. The Closomats and Aerolets help ensure the care we give, even in so personal an area as going to the toilet, is dignified. The Closomats are so much more hygienic, and the staff and I agree they and the Aerolets make resident toileting so much safer for us all too, as they reduce moving and handling considerations.”


The UK's first, and still biggest-selling, supplier of automatic wash and dry toilets, the Closomat automatic shower (wash and dry) toilet has sold over 40,000 units since it was introduced some 50 years ago, many of which are still in daily use 30+ years after being first installed.

Today the Closomat Palma Vita floor-standing automatic toilet is the industry benchmark, being the only one of its kind developed specifically for disabled people.

The Palma Vita is the only unit of its kind to achieve Medical Device Class 1 certification.

Closomat has extended its expertise to now offer a range of accessible toilet, bathroom and wetroom equipment, including shower chairs, ApresShower body driers, and the Aerolet range of toilet lifters.

As a result, the company is unique in delivering in house design advice, supply, installation, commissioning and aftercare service & maintenance through its own dedicated team of engineers.

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