Specifying Lifts for Care Homes
A helpful guide on the process of specifying lifts for nursing and care homes and all the considerations that need to be taken into account when carrying out this process…
Care homes - a growing industry
With the growing ageing population an increasing concern, at around 11.8 million aged 65 and over in the UK (Mid-2016 Population Estimates UK Office for National Statistics, 2017); it’s hardly surprising that the industry continues to grow so quickly.
There are now an estimated 4,699 Nursing homes and 6,023 Residential Care homes in the UK. (Age UK estimate calculated from Care of Older People UK Market Report, Laing and Buisson, 2017).
The fundamental standards of care as set out by the Care Quality Commission (CQC, 29 May, 2017), the independent regulator of health and social care in England state that care must be person-centred (tailored to the individual service user), service users (residents in care homes) must be treated with dignity and respect and safety is paramount at all times (risks must be evaluated during any care or treatment pathway).
When it comes to the premises and equipment within care homes the guidelines state that ‘The places where you receive care and treatment and the equipment used in it must be clean, suitable and looked after properly.’
With so many people now in residential and nursing care across the UK, it’s hardly surprising that there has been increase in the requirement of lifts for the care sector.
The purpose of lifts in residential homes
If your building is more than one storey/level and the people within your building have, or may have in the future, mobility issues you must supply a vertical lift.
Lifts play an integral role in helping to maintain the safety of residents at all times. For those who require a lower threshold of care (within residential care homes for example), user-friendly and accessible lifts can help to increase their level of mobility and therefore allow them to maintain their independence for longer.
For those who require a higher level of care and handling such as 1:1 or in some cases 2:1 assistance from carers, the use of a care home lift enables carers to safely move residents between floors and around all areas of the care home, ensuring person-centred care can be delivered at all times.
Lifts also help to ensure the safety of carers and limit the risk of accidents or injury for both residents and carers when it comes to manual handling. Getting this requirement right can help to ensure the well-being of employees/carers within your facility as it will help to ensure the safe movement of everyone, around the building.
What types of lifts may be suitable for a care home?
For guidance on lifts we look to Part M of the building regulations, Volume 2 (Buildings other than dwellings) that deals with the accessibility and use of buildings. Part M, states that the preferred solution to enable disabled access is a passenger lift. But it also recognises that due to site constraints it is sometimes the case that a passenger lift cannot be accommodated, so platform lifts can be specified in existing care homes; largely due to the building constraints and layout of existing facilities.
Passenger lifts accommodate a high number of people (between 3-33 persons), or mobility equipment, travel over multiple floors (up to 40 metres) and operate at a speed of >0.15 metres per second.
The most common passenger lift sizes for care homes are a 13-person stretcher passenger lift, followed by an 8-person model.
The benefit of a 13-person stretcher lift is it not only takes multiple wheelchair users but can also accommodate a hospital/care bed. Normally in larger care homes two passenger lifts are provided in case of breakdown and during servicing, typically a 13 person stretcher lift and the other a standard 8 person lift suitable for accommodating a wheelchair.
Platform lifts can travel up to 12 metres at a steady speed (slower than passenger lifts) of <0.15 metres per second. These lifts are for occasional rather than continuous use.
The most popular platform lifts sold by Stannah into care homes over the last five years have been the Midilift SL and the Piccolo.
The Midilift SL accommodates a wheelchair user an attendant or up to 4 people, so is a cost-effective option for care home operators, but it does come with constant pressure buttons so people with arthritic hands can fatigue. The Piccolo can fit up to 5 people and has the benefit of one-touch controls and sliding doors which can allow for easier access for residents; although this option may not always fit inside smaller buildings.
As lifts are used frequently within most care homes (both residential and nursing) a passenger lift should always be installed wherever possible.
What are the key considerations when deciding what types of lifts are required?
1. Lift positioning and specification considerations
The frequency of use of the lift must be carefully considered along with the occupancy of the home. For safety reasons, all lifts must have a clear ‘waiting’ space in front of them and should be located adjacent to central facilities. If lifts are used for regular access to daily dining facilities or to access community areas by many then this will influence the type of lift/s required.
Residential care homes with a higher number of residents or nursing homes where the mobility of residents tends to be more limited, may require a greater number of lifts. Nursing homes may also require slightly larger lifts to accommodate extra equipment or carers to assist residents (sometimes 2:1 care is required for lifting and handling of residents) to ensure extra safety.
Once the number of lifts and types of lifts required for the building has been determined then the next step is to consider the special requirements of residents. As well as mobility issues, residents may have a cognitive or sensory impairment, a learning disability or a mental health condition that causes them particular distress, or they may even present with dementia this is where the lift specification plays an important part in ensuring a comfortable ride.
We would recommend considering the following:
- Controls - As a general rule, access doors or lift controls must be easy and intuitive to use. Lift controls should be in a logical position adjacent to the lift where their function and operation is obvious.
- Lift signage and lighting - should make lift entrances easy to locate and use. Access doors to stairs and lifts should be well lit and clearly distinguishable from their background by using a different colour or tone.
- Lift finishes - For both floors and walls mirrored interiors, shiny or swirly surfaces are not recommended finishes for any lift in a care home.
- Floor - Provide a continuous floor finish and colour from the corridor into the stairs or lift.
- Walls - Use a contrasting colour or tone so that the handrail stands out clearly from the background.
- Mirrors - Consideration should be given to the use of mirrors within lifts as these may cause confusion to residents with dementia* and visual impairment. They can not be included in the specification, or if they are provided, alternative approaches such as use of manifestations can provide an effective but decorative solution, although will likely require approval from building control.
*Similarly, care must be taken with lift announcements to ensure they do not startle or confuse a person with dementia.
- Announcements and communication devices - Always ensure that the lift has a verbal system, which clearly advises passengers of their location, door movements and arrival at their destination. All lifts require an emergency communication device to enable trapped passengers to notify someone they are trapped in the lift. If the residents are likely to be deaf then we would recommend the use of an induction loop.
As well as the standard emergency call panel, normally positioned on the wall of the lift, it’s a good idea for care home operators to ensure there is also an emergency button positioned near the ground floor of the lift, in the event of an unsupervised fall/incident.
- Lift specification for dementia - We have produced some specific guidance on lift specification for care homes and hospitals with dementia in mind. Another useful reference is the design audit tool, produced by the Dementia Services Development Centre (DSDC), which provides a framework for making decisions about design and spaces for people with dementia. The tool can be applied to a range of existing and new buildings within a range of settings such as care homes and awards care homes a gold, silver or bronze standard depending on how the lift (along with other building elements) conform to essential and recommended points.
2. Following safety guidelines & regulations
It’s important to be aware of all relevant standards and guidelines when deciding which lift is best suited to your care home requirements. These are the key ones to be aware of:
Lift Standards & Regulations - these vary dependent on lift type and specification.
The ‘Fundamentals of Standard Care’ as laid out by the independent regulator of health and social care in England, the Care Quality Commission (CQC), when setting up any new care home or making significant changes to any existing facility.
And finally, once any lift is installed, it becomes the responsibility of the care home owner to ensure that the lift equipment is regularly serviced and examined at suitable intervals by a competent person. As the legislation surrounding existing lifts is complex, compliance with these regulations tends to be completed with the assistance of a lift service provider.
3. Breakdowns & emergencies
Spending time considering which style of lift is the most suitable for the residents under your care is certainly worth doing, particularly in the event of an emergency. Whether a Simultaneous Evacuation strategy, a Horizontal/progressive evacuation strategy or a Delayed Evacuation strategy is best for your care home you need to be certain that there are adequate numbers of staff available to implement the emergency plan.
It’s essential for every care home to have a backup in the event of a breakdown or for use when a lift is out of action due to a routine inspection/maintenance.
As part of any lift service plan, there are options for 24 hr emergency call-outs, normal working hours emergency breakdown cover, repairs and supplementary testing, it is, therefore, important you consider what type of lift servicing plan is required by the care home.
It’s also paramount that alternative methods to lifts can be used to exit the building in the event of an emergency. Most lifts (unless specifically equipped to do so) cannot be used more evacuation or in the event of the fire, so stairs and fire escapes must as part of any building management evacuation plan.
As the ageing population continues to grow, it’s inevitable that so too will the need for residential and nursing homes as well as the requirement for adequate lift facilities.
For any lift in a care home we would recommend considering:
The type and number of lifts the building requires, subject to building regulations and the requirements of the nursing home, e.g. to transport beds and accommodate undertaker requirements
That the lift specification takes into account the residents need both audibly and visually
How the ongoing lift, maintenance and repair will be managed post installation
Stannah has supplied and installed hundreds of passenger and platform lifts for residential homes (both new and existing). We’re also hard at work keeping these lifts in good working order to ensure every care home offers a high level of service to all its residents.http://www.cqc.org.uk/
With nearly 50,000 installations across the UK and over 92,000 units in our service portfolio, we offer a wide range of lift solutions and services to move people and goods. Take a look at our product range or simply get in touch.Contact Us