Design for Independence (DfI) was recently asked to help a client adapt a newly purchased property.  The client had had suffered a brain injury after a serious accident.  She had been left wheelchair dependent and needed 24-hour care. A large proportion of her insurance award had been spent on this property.

Unfortunately for the client, like so many other clients we have worked with, this property was highly unsuitable as it did not lend itself to the adaptations we knew were necessary.  Had we been consulted from the beginning, we could have assisted with the property search and saved the client the heartache and expense of purchasing a property that could never properly meet her needs.

Overview of the property

The property in this case study was made up of two separate converted barns – one single and one two- storey – linked by a central entrance hall. The property had four bedrooms, three reception rooms, one dressing room, four bathrooms and a ground floor WC.  The bedrooms all had en-suite bathrooms, two in each barn.  The property had one flight of stairs leading from the hall to the landing on the first floor.

Externally there was a detached garage, a large parking area and a step down to the approach to the main entrance. The garden was partially covered by gravel.

Such a spacious property would superficially seem ideal for adaptation to suit a disabled person. However, the DfI specialist housing occupational therapist – with her unique clinical/care/housing skills mix – identified a number of serious problems with this property.

Moving around the property

The property had two wings and two levels, meaning that the client had a large distance to cover to get from one end of the property to the other. She also needed a through floor lift to get upstairs.  The location for the lift hadn’t been identified prior to the purchase, and when our occupational therapist (OT) visited the property it was obvious that the installation would require the reconfiguration of rooms both on the ground and first floors. A specialist housing OT would have considered the accessibility between floors for a wheelchair user prior to purchase and the subsequent work would have been reduced to an affordable level.

Access to the property from a vehicle

It was neither safe nor comfortable for our client to get from their car and into the property as she had to negotiate a step down to the front door. This problem could have been overcome with a ramp; however, in this case there were no possible ramp layouts as the gradient was at more than 1:2, too steep an incline for a wheelchair to travel up and down.

Floor levels

There was a very deep step from the hallway into the reception room because of significant differences between the floor heights in the two different barns. Considerable work was therefore required to provide unrestricted wheelchair access. A step lift could not be used because of a low beam restricting head height.

Moving and handling with care staff

Due to her clinical and care background, our OT understood our client’s care needs, including the importance of being hoisted for bathing. As a specialist housing OT, she was immediately aware that the property was unlikely to be able to support ceiling track hoists (due to irregular floor beam construction), and that the hoists would not be able to travel between any of the bedrooms and their en suite bathrooms (due to solid walls and low beams).  It was economically unfeasible to overcome these structural problems and the care team was forced to compromise when transferring the client from her bedroom to her bathroom, increasing the potential risk of accidents and injury.   This risk was compounded by the fact that there was a particularly low beam in the client’s bedroom

Toilets

The client’s bedroom door was very narrow and it was not possible to widen it significantly.  In order to give an adequate wheelchair turning circle into the room, a width of at least 1200mm had to be available in the corridor immediately outside the door. However, the corridor to the client’s bedroom was very narrow (750mm in places) and was also obstructed by radiators.  Unfortunately, the alternative bedroom in the single storey building was no better in terms of access; it had a very narrow opening into the en suite bathroom, which could not be widened due to the large solid wall.

Access to the client’s bedroom

 The client’s bedroom door was very narrow and it was not possible to widen it significantly.  Therefore, in order give an adequate wheelchair turning circle into the room, it was important that the corridor was wide enough – in this case greater than 1200mm. However, the corridor to the client’s bedroom was very narrow (750mm in places) and was also obstructed by radiators.  Unfortunately, the alternative bedroom in the single storey building was no better in terms of access; it had a very narrow opening into the en suite bathroom, which could not be widened due to the large solid wall.

In summary

The rooms identified for use by the client had many problems: deep steps, ceilings and beams that could not accommodate hoists, narrow corridors/doors, and poor access to en suites and WC.  The upstairs rooms were more suitable, but these could not be accessed as there was no through floor lift, and it would have been very costly to install one.

This case highlights that it is vital for a specialist housing occupational therapist to undertake property search for disabled clients as they have the right mix of skills and knowledge – clinical, care and housing.  They know the equipment that will be used and understand the implications this has on the structure and layout of a property.