Toilet Facilities, Continence Support & Capacity Management

1. Purpose

This policy sets out how Dementia Active manages toilet facilities, continence support and capacity across all centres.

The aim is to ensure that toilet provision and personal care support remain safe, dignified, accessible and appropriate for the number and needs of members attending each day.

This policy applies to all Dementia Active centres, including but not limited to Chipping Norton, Banbury and any future Dementia Active sites.

2. Policy Statement

Dementia Active recognises that people living with dementia may experience:

• Urgency when needing the toilet.
• Anxiety around locating or accessing toilet facilities.
• Continence difficulties.
• Reduced awareness of toileting needs.
• Reduced ability to communicate personal care needs.
• Mobility difficulties or increased falls risk.
• A need for discreet support with toileting, pad changes or personal care.

Dementia Active is committed to ensuring that members are supported in a way that protects their privacy, dignity, safety, independence and wellbeing.

3. Centre Capacity

Each Dementia Active centre will have a maximum daily attendance level based on a balanced assessment of:

• Available floor space.
• Staffing levels.
• Volunteer support.
• Fire safety and emergency evacuation arrangements.
• Accessibility needs.
• Member dependency levels.
• Availability of toilet facilities.
• Availability of accessible toilet facilities.
• Ability to provide safe and dignified personal care.
• Transport arrival and collection arrangements.

Attendance numbers must not be increased without a review of the above factors.

4. Toilet Provision

Each centre must maintain suitable toilet provision for the number and needs of members attending.

Toilet provision may include:

• Standard toilets.
• Accessible toilets.
• Toilets suitable for members using mobility aids.
• Toilets with sufficient space for staff or carer assistance where required.

Accessible toilets should be prioritised for members who:

• Use mobility aids.
• Require additional space.
• Have mobility difficulties.
• Require staff or carer support.
• Need assistance with toileting, clothing, continence products or transfers.

Where possible, members who do not require accessible facilities should use standard toilets.

5. Toilet-to-Member Ratio

Dementia Active will consider toilet-to-member ratios when setting safe attendance levels at each centre.

For example:

• Chipping Norton operates with 3 toilets available for member use and a maximum attendance of 36 members. This provides a ratio of approximately 1 toilet for every 12 members.
• Banbury operates with 3 toilets per floor and may accommodate up to approximately 45 members, providing a ratio of approximately 1 toilet for every 15 members on the relevant floor.

These ratios are considered appropriate for a dementia day service where members attend structured activities and toilet use is spread across the day.

However, ratios will not be considered in isolation. Dementia Active will also consider member dependency, continence needs, staffing levels, building layout, accessibility and any individual risk factors.

6. Managing Peak Demand

Staff recognise that demand for toilets may increase during:

• Arrival periods.
• Refreshment breaks.
• Before and after lunch.
• Before outings or activities.
• Prior to transport collection.
• During periods of increased anxiety or confusion.

To reduce congestion and waiting times, staff may:

• Encourage staggered toilet use.
• Offer discreet reminders throughout the day.
• Support members to access facilities before activities begin.
• Monitor queues and respond promptly to urgent needs.
• Prioritise members with known continence needs.
• Ensure members who require support are assisted without unnecessary delay.

7. Personal Care and Continence Support

Dementia Active may support members with personal care needs where this can be done safely, appropriately and with dignity.

This may include:

• Prompting or reminding members to use the toilet.
• Supporting members to locate toilet facilities.
• Assisting with clothing where appropriate.
• Supporting members with toileting.
• Supporting pad changes.
• Supporting members following continence accidents.
• Providing reassurance and privacy.
• Liaising with families or carers regarding continence needs.

Personal care support will only be provided by suitable, experienced staff or carers who have the appropriate knowledge, confidence and competence to provide dignified care.

All staff or carers providing personal care support must have an appropriate DBS check in place. Dementia Active will ensure that safer recruitment procedures are followed and that staff suitability is reviewed as part of ongoing management and supervision.

Where a member has regular or significant personal care needs, Dementia Active may request a care plan, continence plan or further information from family, carers or professionals to ensure support can be provided safely.

8. Dignity, Privacy and Consent

All toileting and personal care support must be delivered in a way that protects the dignity, privacy and rights of the member.

Staff must:

• Knock before entering toilet or personal care areas.
• Explain what support is being offered.
• Seek consent wherever possible.
• Use discreet language.
• Respect personal preferences.
• Provide privacy during toileting and changing.
• Avoid unnecessary exposure.
• Dispose of continence products safely and hygienically.
• Record concerns or incidents appropriately.
• Report any safeguarding concerns immediately.

Where a member lacks capacity to consent to specific personal care support, staff must act in the member’s best interests and in line with Dementia Active safeguarding, dignity and care procedures.

9. Hygiene and Infection Control

Dementia Active will maintain appropriate hygiene standards in all toilet and personal care areas.

This includes:

• Regular cleaning of toilet areas.
• Handwashing facilities.
• Access to soap, paper towels or hand-drying facilities.
• Safe disposal of continence products.
• Use of gloves and aprons where required.
• Cleaning of affected areas following accidents.
• Reporting and responding to infection control concerns.

Toilets should be checked regularly throughout the day, particularly during busy periods.

10. Accessible Toilet Priority

Accessible toilets should remain available for members who require them.

Where possible:

• Staff and visitors should avoid using member toilets unless necessary.
• Cleaning and maintenance should be scheduled to minimise disruption.
• The accessible toilet should not be used for storage.
• Access routes to toilets should remain clear at all times.

11. Monitoring Capacity and Need

Management will regularly review:

• Number of toilet-related incidents.
• Waiting times or congestion.
• Member feedback.
• Family or carer feedback.
• Continence-related concerns.
• Changes in member dependency levels.
• Staffing levels.
• Number of members requiring personal care support.
• Suitability of toilet facilities.
• Any safeguarding, dignity or infection control concerns.

If evidence suggests toilet provision or personal care capacity is becoming insufficient, management will review:

• Daily attendance limits.
• Session structure.
• Staffing levels.
• Member support plans.
• Use of accessible facilities.
• Building arrangements.
• Additional toilet provision where feasible.

12. Attendance Limits

The maximum attendance level for each centre is based on the facilities available, including toilet provision, accessibility, staff support and the ability to provide dignified care.

Any proposal to increase member numbers must include a review of:

• Toilet availability.
• Accessible toilet provision.
• Staffing levels.
• Member dependency.
• Personal care needs.
• Health and safety considerations.
• Fire evacuation arrangements.
• Dignity and safeguarding implications.

13. Responsibilities

Management are responsible for:

• Setting safe attendance levels.
• Reviewing toilet and personal care capacity.
• Ensuring staff are appropriately recruited, DBS checked and supported.
• Ensuring policies and risk assessments are reviewed.
• Responding to concerns or incidents.

Staff and carers are responsible for:

• Supporting members with dignity and respect.
• Reporting toilet-related concerns.
• Following infection control procedures.
• Maintaining privacy.
• Recording incidents or continence concerns.
• Escalating safeguarding concerns.

Volunteers must not provide intimate personal care unless specifically authorised, trained, DBS checked and deemed appropriate by management.

14. Review

This policy will be reviewed annually or sooner if there is:

• A significant change in centre occupancy.
• A change in toilet provision.
• A change in member dependency levels.
• An increase in continence-related incidents.
• A safeguarding, dignity or infection control concern.
• A change in service delivery or building layout.

Andrew Gill 08/06/2026

Review 08/06/2027