Agenda for Scrutiny Panel on Publicly Accessible Toilets on Monday, 11th February, 2013, 2.30pm

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Agenda and draft minutes

Venue: Committee Room 1, Brighton Town Hall. View directions

Items
No. Item

6.

Chair's Introduction

    Minutes:

    The Chair welcomed witnesses to the second public meeting of the panel, which was focussing on the needs of particular groups who use publicly accessible toilets in Brighton & Hove.

     

7.

Procedural Business

    Minutes:

    There were no declarations of interests and party whip.

     

8.

Minutes of the previous meeting

    The minutes of the previous meeting on 25th January are to follow.

    Minutes:

    The panel agreed the minutes of the meeting on 25th January 2013.

     

9.

Witnesses

    Witnesses will include:

     

    1. Jan Jonker, Head of Strategy and Projects, Cityclean and Jo Jones, Project Officer, Cityclean

    2. Jason Carlisle, Regional Campaigns Officer, Mencap re: Changing Places Scheme

    3. Ruby Kearns, on behalf of the Parent Carers’ Council

    4. Dr John Hastie, Involvement Officer, Brighton & Hove Federation of Disabled People

    5. Andy Player, Crohn’s and Colitis UK, Brighton & West Sussex Group

    6. David Watkins, BHLink  

    Minutes:

    City clean

     

    Jan Jonker (JJ) and Jo Jones (J Jones) explained to the panel that they were here to outline their progress on the Use our Loos scheme. J Jones explained that the scheme was set up in 2000 but there had been problems in getting businesses to join, then remain, in the scheme. Their concerns included:

     

    ·        Anti-social behaviour (ASB)

    ·        Opening up their premises to ‘all and sundry’

    ·        Costs incurred such as water metering, cleaning and supplies

    ·        Insurance implications

     

    Examples of participating businesses include Churchill Square, M&S and BHS (who had recently left the scheme). There were difficulties in locations such as Kemp Town, which has smaller businesses that either don’t have accessible toilets or would be reluctant to open them up to the public. Woodingdean and Western Road (where McDonalds and coffee shops did not want to know) were other areas where businesses did not want participate. Pubs tended to be more positive about the project, but a lot of potential users do not want to go into them to use the toilet.

     

    City clean had tried to encourage businesses to join, but did not offer any financial incentives unlike some other local authorities. Through BHLink, they had found about the Can’t Wait Card and were developing a proposal to link this card to the Use our Loos scheme (see attached briefing paper). City clean would like to investigate whether more businesses would sign up to the scheme, if it would be primarily for holders of this card. That rather than open up their toilets to ‘the world and their wife’ it would just be to people who had specific needs. A key target would be to persuade GP surgeries to sign up to this scheme.   

     

    The panel felt that having heard about the difficulties of encouraging businesses to participate in the scheme, that this proposal sounded like a ‘tangible and sensible way forward’.

     

    Q: Will businesses have heard about the ‘Can’t Wait Card?’

     

    J Jones told the panel that the intention was to approach businesses, such as GPs surgeries, and tell them about the scheme. If the organisation signed up they would be put on a list (not distributed publicly) which would be available for ‘Can’t Wait Card’ holders. We would have this as a downloadable document on the website, which anyone could access, but that would be signposted for those with the additional need. City clean would contact these businesses every 6 months to check how it was working out in practice.

     

    Q: Could you have a scheme where businesses had to opt out of opening up their toilets to the public?

     

    Businesses, such as GPs surgeries need to know what scheme they are part of, or users could risk being turned away from the premises. To get such organisations to join this scheme would be a good thing for the city and we would be the first local authority to promote the Can’t Wait Card.

     

    J Jones explained that they were preparing a database for the project but hoped to launch the project with the support of the panel.

     

    David Watkins (DW) suggested that GPs should not be approached until after 1st April when the new health laws came into power, formalising the commissioning  arrangements.

     

    JJ hoped that this proposed scheme would be reflected in the recommendation(s) of the panel and that they would approach Tom Scanlon in the first instance.

     

    J Jones explained that a benefit of the Can’t Wait Card was that it could be shown to people to explain why the holder needed to use the toilet. Businesses had been concerned about opening up their toilets to all because they were concerned about:

     

    ·        Sexual activity

    ·        Drug use

    ·        ASB  

     

    The showing of a card could reassure the business that the person had a specific medical need to use the toilet and did not wish to damage the facility or behave inappropriately there. City clean hoped existing participants in Use our Loos to move to this scheme and then it extend it to a wider group of organisations e.g. GPs surgeries. If GPs could be persuaded to join then this would represent almost 50 businesses opening up their facilities and if another 50 organisations joined too, then this would provide 100 extra facilities for people who were planning to spend the day out in the city.

     

    The panel felt it would be showing civic leadership and offered support to these proposals and would encourage the leadership of the council and the Clinical Commissioning Group leaders to work with local GPs to ensure that this happened. The scheme could give businesses confidence that opening up their facilities would not be a ‘free for all’.

     

    A member of the panel commented in relation to their retail experience that the boss of an organisation would say:

     

    ·        What’s in it for me?

    ·        That seems like a whole load of trouble: not worth my while

    ·        I don’t have the resources to check that my facilities are clean

     

    Q: How can you present this scheme to businesses in a way that would make them want to take part and allay their concerns about issues such as insurance and health & safety?

     

    J Jones explained that they would be asking businesses who already opened up their toilets for customers (or patients, in the case of GPs) would have these premises already insured, and designed, for public use. For example some businesses have toilets which are for the use of customers only, it just would be a question of putting a business like that who wanted to participate onto a list for Can’t Wait Card holders, including post code information. This would also deal with businesses who do not want to display another sticker in their window. So the scheme would be aimed at businesses who already had customer toilets, opening them up to non-customers in need.

     

    Q: Would you negotiate with the NHS as a single body or contact individual surgeries about the scheme?

     

    JJ told the panel that he hoped that there would be a scrutiny panel recommendation on this proposed scheme and on that basis City clean would approach Tom Scanlon as the first point of contact.

     

    Mencap

     

    Jason Carlisle (JC) explained that Michael Le Surf from Mencap was the national lead on the Changing Places campaign. He was pleased to see that Brighton & Hove already had one Changing Places toilet but it was not in a very accessible location. The campaign would like to see a Changing Places toilet in every large scale building, such as arts venues and shopping centres.

     

    There were nearly 250,000 people in the country who cannot use standard accessible toilets, because access was needed for the person and their carer and the provision of an adjustable bench. This meant almost a quarter of a million people who would not be able to visit places like Brighton & Hove due to the lack of facilities, even though it was a transport hub and a hub for tourists. No-one should miss out on being able to visit Brighton & Hove, or if a resident not being able to travel round the city. 

     

    The campaign wanted to persuade Brighton & Hove to build more Changing Places toilets. A set size of building was not needed, but sufficient room for a person and up to two carers (if needed) and room to clean; along with a height adjustable bench and hoist. Very specific equipment was needed and space standards.   

     

    Q: Can one adapt existing toilets?

     

    JC explained that it was more effective to secure the provision of such toilets in new buildings, like supermarkets.

     

    According to J Jones, the Colonnade had been chosen as it was one of the only sites that was big enough and one was being installed at the Level because it was included at the beginning of a development.

     

    Q: Do Changing Places need to be accessed using RADAR keys?

     

    JC told the panel, that there was no statutory guidance, so one can determine how the access is given to the facility.

     

    Q: How can one afford to build this type of facility?

     

    JC explained that this toilet needs to be in addition to general provision, rather than instead. There was no specific fund for this kind of toilet, but funding can be gained from grants. For example the toilet built at the Barbican was funded by the Lottery with Action for Children.

     

    The panel felt that there were sources of funding out there and in order to develop bids, it would be useful to know roughly how many Changing Places toilets were needed in the city. 

     

    JC would find it hard to quantify, as he was not sure how many people with multiple disabilities lived in the city. However they think at least 2-4 were needed, for example at:

     

    ·        Station

    ·        Pier

    ·        Churchill Square

     

    JC agreed that he would provide information on other examples of successfully building Changing Places toilets, e.g. other local authorities and retail outlets.

     

    The panel agreed that when looking at granting planning permissions the potential for Changing Places toilets should be considered.

     

    Q: What are the ongoing costs of maintaining this kind of toilet?

     

     

    JC appreciated that there were ongoing costs in maintaining these toilets, so it would be useful to partner with organisations such as supermarkets. Why shouldn’t people with wheelchairs have access to the same facilities?

     

    The panel would like to know more about national progress with this campaign, whether central government recognise the importance of such facilities and if they provide any assistance for councils or businesses looking to install Changing Places toilets.

     

    Parent Carers’ Council (PaCC)

     

    Ruby Kearns (RK) told the panel that PaCC represented the families of disabled children from 0-25 years. A lot of the needs are the same as those provided in Changing Places toilets e.g. hoists. Roll over seats were not provided in Brighton & Hove. Like many of the families she represented RK had a disabled son. Because he cannot hold himself safely on a toilet, she had to sit behind him and hold him on the toilet, but when he grows bigger she will not be able to fit. Parent carers of children who used wheelchairs were susceptible to back pain and injury and we were often forced to undertake difficult transfers in these toilets.  

     

    There was a need for hoists in accessible toilets, otherwise two people would be needed to transfer her child onto the toilet when he was older.

     

    Q: What is your experience of using standard disabled toilets?

     

    RK explained that they were not big enough for power chairs and did not provide sufficient space for two carers. Due to lack of changing benches, parent carers were forced to change their children on dirty floors. She was used to having to carry her child through busy places e.g. shops, trying to find a suitable toilets.

     

    She had not seen any information provided about the location of accessible facilities, and neither had the other people she had asked. This included the support group she ran for families with disabled children aged 0-8 and the wider PaCC community.

     

    RK liked the idea of an App but had not been able to track one down. She wondered if it would carry information about where hoists were located in toilets.

     

    There was a cultural and historical aspect to not providing such facilities, that disabled people used to be institutionalised. It was necessary to recognise the needs of all along the spectrum.

     

    Q: Are there any toilets which you can use easily?

     

    RK told the panel it was always necessary for parent carers to plan where they  were going. Many wheelchair users, particularly females, have to be transferred to a toilet to urinate. This was a growing problem as due to medical advances in elderly and premature baby care, there were growing numbers of people with disabilities and older people. The Changing Places facility at the Colonnade was great but is far out if you are not at that end of town, an ideal location would be the Churchill Centre. Although at this shopping centre was a woeful lift, and parents of disabled children had been abused by other people for using the lift and have to compete with many parents with buggies and other wheelchair users or elderly people, often waiting for a long time before you can get on the lift.

     

    Q: Can toilets be built that can meet all needs? Would it be possible to develop facilities that met the needs of people with disabilities, parents with buggies and breastfeeding women?

     

    RK felt that it would be difficult to find a location which could provide sufficient space, especially if one was using a power chair. Private space was needed for these functions, while breastfeeding would take up a lot of time that would lead to people with differing needs competing for the facilities. It would be really helpful to have larger units, so that you could take push chairs into a facility.

     

    Q: What would be the gold standard of provision for parents of children with disabilities?

     

    RK believed that it would mean more facilities sited throughout Brighton and Hove. She suggested to keep costs down and negate the need for each facility to be staffed, there could be a supervisor on a bike that could move round these facilities to offer assistance and keep them clean. It would be good to have key codes to gain entry rather than keys, so one would know who had last used the toilet in order to discourage abuse.

     

    The panel were keen to hear from RK and PaCC if there were any further suggestions they wished to provide.

     

    Q: Do you think provision needs to be placed at strategic points, rather than just placing at Churchill Square otherwise it will not meet the needs of people who live in the outer reaches of the city?

     

    RK repeated that she felt more facilities were needed, for example an accessible toilet at Boundary Road. It would be good to have facilities in well populated areas to reduce the level of ASB, for instance parents might find Madeira Drive isolated and intimidating on an evening.

     

    The panel were keen to obtain the latest British Standard for accessible toilets and see if our facilities meet those standards especially post the DDA. If one is meeting high levels of accessibility needs, then one is catering for all.

     

    Q:  How do you think we compare with other councils?

     

    J Jones told the panel that Brighton & Hove compared well in the number of general accessible toilets in relation to the city’s population. However this was a very spread out city and in some localities a lower level of provision would be needed. We received a lot of calls from other local authorities to ask how were managed to sign up businesses and leisure centres to participate in Use Our Loos.

     

    JJ informed the panel that the £25,000 construction costs of the Changing Places toilet in Madeira Drive was funded by Wettons. J Jones explained that this was a fully attended site, to ensure that the people using the facility were able to use the hoist. The users were expected to sign a declaration that they knew how to use a hoist. The key issue was to ensure that the general public used toilet facilities responsibly. RK suggested that a membership scheme could be effective.

     

    JJ told the panel that the facility at the Level would be more accessible and had been sited there due to the funding opportunity at that location. He thought that it was likely that the city would only have two such facilities. J Jones explained that it would not be possible to charge for Changing Places toilets as one is not allowed to charge for accessible toilets. Access can be gained with the RADAR key and it is fully automatic. JJ repeated that the costs involved in charging: the provision of an attendant and installing an accessible entrance as well as a turnstile, meant that there was not a business case for charging to use toilets.

     

    Q: Is there a charge for the Can’t Wait Card?

     

    J Jones explained that the revenue raised by the charge for this card went to the charity.

     

    The panel agreed that it was useful to be reminded of the need for accessible toilets and asked the witnesses to forward any relevant information about this issue to Karen Amsden using Karen.amsden@brighton-hove.gov.uk

     

    The Fed Centre for Independent Living

     

    Dr John Hastie (JH) told the panel that it was a challenge to capture the needs of people with disabilities, which included:

    ·        Wheelchair users

    ·        People with long term health conditions

    ·        People with guide dogs

     

    However, there was a higher need in the disabled population for toilets. For example, while he was entirely continent he had to use a toilet every hour or two so needed there to be an accessible toilet in range. The standard range of accessible toilets meet the needs of most people and it was important to maintain good standards for all of these facilities toilets. Changing Places toilets were very good, but a full range of toilets were needed. The main comments he wanted to make about the current provision were:

     

    ·        Where there are accessible toilets, these tended not to be open or hard to find in the evening

    ·        A lot of pubs and restaurants do not have accessible toilets, which mean that public toilets are needed to fill that gap and enable people with disabilities to go out in the city

     

     JH believed that Changing Places toilets were very good for those on a longer day out in the city, where you would be more likely to need that toilet during that day. Even if one used continence pads, it may be necessary to change them while you were out. It felt unfair to be discussing whether to charge for accessible toilets, as this group are more likely to need the toilet and would feel that they were being penalised.

     

    JH felt that the information provided about public toilets in the city was good. He noticed that the spreadsheet had last been updated in January after there had been some complaints about out of date information.

     

    J Jones replied that they had received feedback from BHLink that changes, in particular the Level closure, had not been updated on the spreadsheet. The previous update had taken place last November and changes were made when there was an alteration to the facilities.

     

    Q: What is your experience of using McDonalds not as a paying customer?

     

    JH told the panel he generally sneaked in, but had been met with a good response when asking to use the toilets. He chose venues to go to on the basis of their accessibility. He had found that accessible toilets often became used as storage cupboards, like a pub JH had visited recently. Light bulbs were often not replaced and often accessible toilets were not maintained to the same standard as general use toilets. Another example was wiring around the shelf. He wondered if BHCC were able to encourage compliance, e.g. using Licensing?

     

    The panel expressed concern that this could mean the toilet was a fire risk and not DDA compliant. In the Planning regime action was taken for failure to comply, so felt that there was no reason why Licensing should not be able to take similar action.

     

    RK thought that these kinds of issues meant there was such a need for publicly funded facilities.

     

    Q: In your experience are toilets in the RADAR scheme being vandalised?

     

    It had not been reported to JH that vandalism was a big issue, but felt that such problems were more likely to be reported to the council. He had not really experienced ASB and thought that it seemed to take place in general use toilets.

     

    Q: What do you think are the key things the council could do?

     

    JH observed the following:

     

    ·        Keep accessible facilities clean

    ·        Provision here was generally good, but not closing any more facilities

    ·        Keep facilities open in the evenings

    ·        The Use our Loos scheme seems good

     

    Q: Do you think there is a case for not providing any general use toilets, but making all publicly available toilets accessible?

     

    JH felt that it was important to have general use toilets as well, because generally accessible toilets are used for a longer stretch of time per visit. Separate accessible toilets were preferred, so that users of accessible toilets did not need to feel they were holding someone up.

     

    J Jones gave an example of a mixed facility being built in Rottingdean where there was one larger accessible toilet alongside general use toilets.

     

    The panel felt that it was important that accessible toilets were for the people who needed them.

     

    JH told the panel that they had been asked by the council last year about getting rid of RADAR keys to enable transgender people to access these facilities. However people with disabilities did not want to get rid of the RADAR key, as usually these facilities are in a better condition then the general accessible toilets.

     

    Crohn’s and Colitis UK, Brighton & West Sussex Group

     

    Andy Player (AP) explained that both Crohn’s and Colitis were bowel conditions and it has been estimated that 1 in 250 people have this condition in the UK. This would represent around 1,000 in the city. The Sussex University Hospital have over 2,000 people on their books in the area with these conditions, which is thought to be a significant underestimation of the true number. Therefore a significant number of people in the city and surrounding areas suffered from these conditions.

     

    The conditions typically begin in teenagers and young adults and there was a whole spectrum of severity of symptoms. The bulk of sufferers here were people of working age who either work in Brighton or commuted. These health conditions have a significant impact on people and can result in hospitalisation when at its most serious, requiring recuperation afterwards. Even when the condition was stable, it would still involve frequent and urgent diarrhoea, acute abdominal pain, the sudden urge to use the toilet and severe fatigue: making it difficult to run to the toilet.

     

    Sufferers experience anxiety, and the need to plan meticulously and know where all the publicly accessible facilities are when going out:

     

    ·        To school

    ·        To work

    ·        Socialising

    ·        Taking care of young children  

     

    For those who had experienced public faecal incontinence the experience could be devastating and impact on their ability to feel engaged with society. While coping strategies often included learning every public toilet in the whole of the city, many people chose not to engage in activities which would mean they needed to go out.

     

    Crohn’s and Colitis UK had carried a survey of around 1,000 young people which found that:

     

    ·        43% felt seriously isolated at the point of diagnosis and for years afterwards

    ·        25% had found that their condition made socialising almost impossible, with 18% attributing this to ‘always needing to know where a toilet was’

     

    A survey of local members in Sussex (around 30 respondents) was conducted in response to the proposed cuts to public toilets in the city in 2012. The survey confirmed that most members needed to use publicly accessible toilets nearly every day, especially when travelling. 75% flagged up the need to have public toilets next to transport hubs and 66% had used public toilets to clean themselves up after experiencing faecal incontinence. The majority carried clean clothes with them, in case they were needed.

     

     

    AP told the panel that when the survey asked where publicly accessible toilets were needed, the response was in all parts of the city, particularly where people:

     

    ·        Travel

    ·        Socialise

    ·        Shop

     

     This would enable them to ‘pursue ordinary activities’.     

     

    The survey asked ‘when do you need public toilets in Brighton & Hove and an emphasis was placed on evenings because:

     

    ·        People were commuting home, returning late from work or attending lectures

    ·        To enable socialising

     

    If asked what changes they would like to see to public toilets:

     

    ·        More not less

    ·        Facilities open in the evening

    ·        While urinals would not help those with Crohn’s and Colitis, it could free up other facilities to be used

    ·        Signposting of toilets

    ·        It was felt that the website information was great and would welcome an App

     

    J Jones explained that the outdated signposts should all be removed now as they now could point to toilets which were not there any more. AP asked if the service could think of other ways to signpost these facilities.

     

    In the experience of AP a lot of people with Crohn’s and Colitis used RADAR toilets especially at railway stations. The provision by Network Rail was quite good, however there were instances of ASB and a rough sleeper using the toilet. It was a big issue that doors were locked after dark, which is a particular problem in winter. People with Crohn’s and Colitis cannot operate on season hours and it would be great to work with the council to resolve this issue.

     

    AP explained that the Can’t Wait Card was provided as part of the Crohn’s and Colitis UK membership and most people joined the scheme if they had the condition or were a relative or carer for someone with the condition. The card was automatically sent out to applicant, so relied on trust but people only tended to use them when needed.

     

    AP’s experience of using the card was mixed, but generally good. The benefit of the card was that it cuts out what can be a very embarrassing discussion with the person working in the premises which has the toilet. In general he had very good responses and had never been turned down. If the business did not have a public toilet, then he had been taken by staff to their toilet and those people had to wait for up to half an hour outside until he had finished using the facilities. However the card was not a guarantee that the organisation will agree, which can be a distressing experience. According to their survey, the majority of respondents said that they would find a shop, if could not find a publicly accessible toilet. Over half did say that they would soil themselves and then go home as soon as possible to clean up. One respondent had reported that they had mostly been refused help when asking if they could access toilets to use.

     

    AP felt that it was important to give people confidence and then the card could be a lifesaver. If the council was to back this scheme and communicated this, it would increase the confidence of card holders. This would raise the awareness of businesses and employers and getting them to understand that people could be in genuine need.

     

    J Jones told the panel that the service was keen to tie this to the Paralympics legacy and the increased awareness of people with disabilities.

     

    The panel felt that accessibility was fundamental and at the core of what was needed. It was important to look at range of measures rather than putting them in a scale of importance. The value of the proposed link between the Can’t Wait Card and Use our Loo is that it ties up needs and accessibility, which could free up resources for higher levels of need. In the evening it would be good to widen the access drawing on resources such as pubs and restaurants.

     

    RK reminded the panel that what was needed was awareness, confidence and compassion. There should not be a problem of quantity, rather it is making sure those toilets meet the needs of a range of groups.         

      

    Q: Why were RADAR toilets locked in the evening, is this a resources issue?

     

    J Jones told the panel that one of the primary issues was that they became a prime site for rough sleepers, which posed difficulties for cleaning staff attempting to close the site.

     

    The panel heard that this meant that vulnerable user groups were then competing for this space and decided that they would like to hear from other local authorities about how they struck a balance on this issue: opening up access v. pressures caused by ASB.

     

    Q: We are aware that one of the issues is that councils have the ‘power’ to provide toilets but not a statutory ‘duty’, is Crohn’s and Colitis UK lobbying national government about this issue?

     

    AP told the panel that he felt it should be a statutory duty on councils.

     

    The panel will consider if it would be useful to lobby government on this issue, as it seemed that this was a fundamental public service which needed to be funded properly.

     

    RK wondered if the DDA legislation was relevant and whether compliance with the standards needed to be more policed and funding offered to assist in complying. What happens to businesses which do not comply, as for example the Café Nero in Churchill Square does not have an accessible toilet. KA to find out the relevant details in the DDA legislation.      

     

    AP suggested that the council should come up with a % it expected to be spent on toilets from any resources secured by the Late Night Levy. That businesses should have to comply with this to avoid a ‘toilet tax’.

     

    A member of the public queried why the collection of human waste was not treated equally with the collection of household waste, in terms of legislation, policy and resources. Another member of the public revealed that he had acted as a mystery shopper today and asked the reception at Brighton Town Hall for a list of accessible toilets and had been supplied after some time with a spreadsheet dated April 2012 which only included 40 toilets. He believed that public access points and Tourism facilities should be able to access up to date information at the touch of a button.

     

    BHLink

     

    David Watkins informed the panel that BHLink had received 80 negative comments about public toilets  ...  view the full minutes text for item 9.

10.

Date of the next meeting

    Minutes:

    The next meeting will take place in Committee Room 1, Hove Town Hall at 10am on 26th February.  

11.

A.O.B

 


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