Bathrooms
continue to participate actively in their own care, even when assistance is required. The way a bathroom is designed can therefore influence not only safety but also the degree of choice and control a person can retain. Simple design decisions often make a
significant difference. Adequate space allows residents to place walking aids where they are most useful, rather than where space permits. Clearly visible controls, accessible storage and appropriately positioned fittings enable many people to perform personal care tasks independently, reducing unnecessary dependence on staff. Where assistance is required, layouts that allow carers to work safely, without rushing or compromising privacy, help to preserve dignity throughout the personal care experience. Maintaining choice is not simply about
independence. Some residents may prefer a bath, while others feel more secure using a shower which is their choice and may maintain long-established comfortable routines. Providing environments that accommodate these preferences recognises that bathing is more than a hygiene task, it is part of everyday life and personal identity. Designing bathrooms that support these choices reflects the principles of person- centred care and helps residents retain control over an activity many regard as deeply private.
Accessibility and cognitive-friendly design Bathrooms play a central role in supporting independence, for many residents, they are among the few remaining spaces where autonomy can be preserved and where most of us would want it preserved for as long as possible. Regulatory requirements emphasise dignity and respect and design is fundamental to achieving both. Design features that improve accessibility
could include: n Contrasting-coloured fixtures, such as
grab rails and toilet seats, which support visual recognition. Effective contrast relies on tonal difference rather than on simply using bright colours.
n Familiar, domestic style fittings rather than clinical or overly modern designs. For example, a traditional toilet with a visible cistern rather than a concealed system with flush buttons.
n Avoid patterned flooring that may appear uneven or hole-like to people living with dementia.
n Grab rails should be positioned to
residents to use it more independently, reducing dependence and supporting dignity. When applied consistently, these design
support natural movement, not merely installed to meet minimum standards.
Equipment integration and safe working practices Equipment to support residents in the bathroom, such as shower chairs, wheelchairs, and other manual-handling devices is often essential, yet it is frequently treated as an afterthought in design. In practice, its use is almost inevitable and must be considered from the outset. Key design principles include:
n Adequate space for using equipment without obstructing movement.
n Appropriate fixture heights, including height-adjustable basins, baths, shower seats and toilets, to meet diverse residents’ needs.
n Thoughtful storage solutions that keep equipment accessible yet unobtrusive.
n Clear sightlines that allow carers to supervise safely without compromising residents’ dignity.
n When equipment use is integrated into the design, bathrooms become safer workplaces and more comfortable personal spaces.
Lighting, acoustics and emotional comfort Good bathroom design considers not only physical safety but also emotional wellbeing. Lighting and acoustics significantly affect how safe and comfortable a bathroom feels and effective design approaches include: Warm, even lighting that avoids shadows
and glare while highlighting key areas. Task lighting around the basin and mirror can support grooming and oral healthcare. Acoustic dampening to reduce echoing,
which can be distressing for people with dementia. This can be achieved through soft-close toilet seats, fabric shower curtains, plants and other soft furnishings.
Calm, familiar colour palettes that avoid clinical tones. A bathroom that feels safe, encourages
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www.thecarehomeenvironment.com September 2026 Kate Sheehan
Kate Sheehan is a highly respected occupational therapist championing understanding the meaning of home for each individual and the impact of poorly designed environments on wellbeing. She was awarded a Fellowship by the Royal College of Occupational Therapists for this work, and she has co-authored and co-authored multiple inclusive design books and guides. She was given an Honorary Fellowship from the University of Worcester in 2023 for her significant contribution to the field of occupational therapy, and is a consultant for Gainsborough Specialist Bathrooms, part of the Gainsborough Healthcare Group.
principles create bathrooms that support safe practice, reduce risk and enhance the resident experience. They transform regulatory requirements from abstract obligations into practical, everyday realities. A well-designed bathroom is not merely compliant, it should enable better care. For care home owners, investing in
bathroom design can reduce staff injuries, improve manual handling practices and demonstrate compliance with regulatory expectations. For carers, it creates a safer, more efficient working environment. Most importantly, for residents, it supports dignity, privacy, comfort and independence during one of the most personal activities of daily living. When legislation informs thoughtful
design rather than merely achieving compliance, bathrooms become environments that support better outcomes for everyone who uses them. n
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