Changing Places toilets: key facts
- A Changing Places toilet is for people with complex and multiple impairments who may need up to two assistants. ADM para 5.6 says it is in addition to accessible toilets and baby changing, not instead of them.
- In England, ADM para 5.7(e) expects at least one in: assembly and entertainment buildings for 350+ people (2,000+ for multi-building sites such as zoos); shopping centres and retail parks of 30,000m²+; retail premises of 2,500m²+; sport and leisure buildings over 5,000m²; hospitals and primary care centres; and crematoria and cemetery buildings.
- The government said the requirement took effect on 1 January 2021 and applies to buildings in scope that are new or undergoing a material change of use.
- Capacity is the combined total of a building's publicly accessible facilities, or the number of fixed seats where people normally sit.
- The Changing Places Consortium's guide sets a room of at least 3m by 4m (12m²), a ceiling of at least 2.4m, a hoist with a safe working load of at least 200kg and a bench at least 1,800mm by 800mm.
- Scotland has its own rule (Technical Handbook clause 3.12.13) with different triggers. Wales and Northern Ireland have their own building regulations.
- Register a new Changing Places toilet with the Consortium so it appears on the official map. Unregistered, users can't find it.
What is a Changing Places toilet?
A room with a peninsular WC, a ceiling track hoist, a height-adjustable adult changing bench, an adjustable basin, a privacy screen and space for the user and up to two carers. A standard accessible toilet has no hoist or bench and is too small for that.
ADM Volume 2 para 5.6 describes them as facilities for people with complex and multiple impairments who may need up to two assistants. The Changing Places Consortium, which runs the official register, lists the core features:
- The right equipment: a height-adjustable, adult-sized changing bench and a tracking hoist system.
- Enough space: for the user and up to two carers, a centrally placed toilet with room either side, and a privacy screen or curtain.
- A safe, clean environment: a wide paper roll for the bench, a large bin for pads, and a non-slip floor.
A shower isn't compulsory for registration, but the Consortium recommends one in settings such as sports centres and swimming pools. It's a designed room, not a Doc M toilet with extras added, and problems usually start when it's squeezed into leftover space late in the design.
Who needs a Changing Places toilet?
People who can't transfer to a toilet on their own or need help with continence pads, and the family or paid carers who help them. Without one, people may be changed on toilet floors or cut trips short.
The Consortium's guide lists users including people with profound and multiple learning disabilities; conditions affecting movement such as cerebral palsy, multiple sclerosis and motor neurone disease; head or severe spinal injuries; people living with stroke; older people who need assistance; and ex-service personnel.
Typically the person can't transfer on their own or has no sitting balance. When the government announced its proposals in 2019, it listed what people face without these toilets: limiting what they drink, sitting in soiled clothing, being changed on a toilet floor, being lifted out of a wheelchair by hand, and cutting trips short. The hoist and adjustable bench also protect the carer, who would otherwise be lifting an adult and bending over a low surface.
How is a Changing Places toilet different from an accessible toilet or a hygiene room?
An accessible toilet suits people who can transfer to the WC themselves or with a little help. A Changing Places toilet adds a hoist, adult bench, peninsular WC and room for two carers. A hygiene room is similar but serves known users, such as pupils at a special school.
| Wheelchair-accessible unisex toilet | Changing Places toilet | Hygiene or changing room | |
|---|---|---|---|
| Who it's for | Wheelchair users and others who can transfer to the WC independently or with limited help | Members of the public with complex needs, plus up to two carers | Known users of a building, such as pupils at a special school or people at a day centre |
| WC position | Laid out for a side transfer from a wheelchair, following the ADM diagrams | Peninsular: room either side for carers | Depends on the users' care plans; often peninsular |
| Hoist | No | Yes, ideally a ceiling track hoist covering the room | Usually |
| Changing bench | No adult bench, and ADM says the accessible toilet shouldn't be used for baby changing either | Height-adjustable, adult-sized | Usually, sometimes with a shower trolley |
| Where the guidance is | ADM Vol 2 paras 5.7-5.10 and diagrams | ADM Vol 2 paras 5.6-5.7, with layout and equipment guidance from the Changing Places Consortium and BS 8300-2 | Sector guidance (for example for schools), not the Changing Places requirement |
For the standard accessible toilet, see our disabled toilet regulations page and our Doc M pack guide. A Changing Places toilet shares some principles, such as visual contrast and an assistance alarm, but you can't buy it as a pack.
Which new buildings in England must have a Changing Places toilet?
Approved Document M para 5.7(e) expects at least one in large assembly and entertainment buildings, large shops and shopping centres, large sport and leisure buildings, hospitals and primary care centres, and crematoria and cemetery buildings.
Under para 5.7(e) of Approved Document M Volume 2, at least one Changing Places toilet should be provided in:
| Building type | Threshold |
|---|---|
| Assembly, recreation and entertainment buildings | Capacity for 350 or more people |
| A collection of smaller buildings on a site used for assembly, recreation or entertainment (for example zoos, theme parks, sport and exhibition venues) | Capacity of 2,000 people or more |
| Shopping centres, malls or retail parks | Gross floor area of 30,000m² or more |
| Retail premises | Gross floor area of 2,500m² or more |
| Sport and leisure buildings | Gross floor area more than 5,000m² |
| Hospitals and primary care centres | No threshold |
| Crematoria and cemetery buildings | No threshold |
What counts as assembly, recreation and entertainment?
The note to para 5.7 lists examples: amusement arcades, art galleries, cinemas, concert halls, conference centres, further education colleges, hotels with function, sport or leisure facilities, public libraries, motorway service areas, museums, places of worship, theatres and university buildings open to the public, plus any other public building or site that meets the thresholds.
New buildings and changes of use
The government's response to its consultation says the requirement applies to buildings in scope that are new or undergoing a material change of use, and that the amendment took effect on 1 January 2021. It said it would research whether a smaller room could work for existing buildings being extended or altered. For alterations and extensions, ask your building control body early rather than assuming either way.
How do you work out whether your building is over the threshold?
For assembly and entertainment buildings, add up the capacity of all publicly accessible areas, or count fixed seats where people normally sit. Approved Document B Volume 2 gives a method if capacity isn't known. Retail and leisure buildings are tested on gross floor area.
The note to ADM para 5.7 says capacities come from the combined total of a building's publicly accessible facilities. In a mixed building, a hall, a cafe and a function room may each be well under 350, but it's the combined total you compare with the threshold.
- Pick the category. Assembly uses are tested on people; retail and sport and leisure on gross floor area; hospitals, primary care, crematoria and cemetery buildings have no threshold.
- Seated venues: count the fixed seats. Others: list each public space and its capacity, using the Approved Document B Volume 2 method where it isn't known.
- Write it down in the access statement so building control can follow it.
Check borderline cases with building control before the layout is fixed. The Consortium points out that it is cheaper to include a Changing Places toilet at the planning and design stage than to make structural changes to an existing building later.
What size is a Changing Places toilet, and what equipment goes in it?
At least 3m by 4m (12m²) with a 2.4m ceiling, according to the Changing Places Consortium's guide, with a ceiling track hoist (at least 200kg safe working load), an adjustable adult bench at least 1,800mm by 800mm, a peninsular WC, an adjustable basin and a privacy screen.
ADM doesn't set the dimensions itself: para 5.6 points to the Changing Places Consortium and to section 18.6, diagram 48 and Annexes F and G of BS 8300-2:2018 (a paid standard). The figures below come from the Consortium's free practical guide and, where marked, the Scottish Technical Handbook.
Room: at least 3m by 4m (12m²). Ceiling height at least 2.4m. Non-slip floor. Direct access from the door into the manoeuvring space. In Scotland, the handbook also expects a door with a clear opening of at least 1m.
Hoist: ceiling track hoist with full room coverage, to BS EN ISO 10535. Safe working load at least 200kg (more recommended), with walls and ceiling strong enough to carry it. Emergency lower and stop, and the safe working load and instructions on display.
Changing bench: wall-mounted or freestanding, at least 1,800mm long and 800mm wide, height adjustable from 300mm to 1,000mm above the floor, working load at least 200kg. A wide paper roll dispenser by the bench.
WC: peninsular (centrally placed) with room for an assistant either side, with vertical grab rails and drop-down support rails on both sides.
Basin: ideally height adjustable, with clear space underneath for a wheelchair user.
Also: a privacy screen or curtain, a large waste bin for pads, an emergency assistance alarm, and (in some settings) a shower.
Hoist types
The Consortium prefers a powered overhead track hoist, which keeps the floor clear. An X-Y track covers the whole room; a straight or curved track only reaches what's under it. Gantry and floor or wall-fixed hoists are only accepted in rooms of 12m² or more, and mobile hoists aren't recommended.
The Consortium doesn't recommend fixed-height changing benches.
What do you need to plan early for a Changing Places toilet?
Fix the location and the 12m² footprint at concept stage, confirm the ceiling can carry the hoist, plan drainage for the WC and any shower, and decide how people will get in.
Location
- Put it on a step-free route, close to other toilets. The Consortium says it must be properly signposted and all staff should know where it is and how to get in.
- ADM says "at least one": on a big site, think about whether one is enough to be useful.
Ceiling and structure
- Get a structural engineer to confirm early that the soffit, or a support frame, can carry the hoist, especially in an existing building or under a lightweight roof.
- Keep at least 2.4m clear height, with room for the track and motor. The guide says lights and alarms should be shallow or recessed and away from the track.
Drainage, water and ventilation
- A peninsular WC sits away from the side walls, so check the soil route early.
- If you include a shower, the Consortium's guide says the shower floor should fall no steeper than 1:50 to a recessed floor outlet, ideally by a wall or in a corner, away from the turning space. The Consortium warns that shower trolley waste water may contain faecal matter.
- The guide says the room should be adequately ventilated.
Power: agree power and charging positions for the hoist, bench and alarm with the supplier before first fix. Electrical work is for a competent electrician.
Access and opening hours
The Consortium leaves security to the venue, after a risk assessment. Options include open access, a RADAR key, or access through reception. Whatever you choose, it must work whenever the building is open.
How do you hand over and register a Changing Places toilet?
Test the equipment, train staff, set up servicing, then register the toilet with the Changing Places Consortium so it appears on the official map.
- Test and commission the hoist, bench, adjustable basin and alarm before you accept the work. Make sure instructions and safe working loads are on display.
- Set up maintenance. The Consortium says the venue that installs the toilet is responsible for its upkeep. Hoists and powered benches need servicing, and the Consortium recommends considering a supplier maintenance contract. Ask your supplier what inspection and servicing the equipment needs.
- Train staff on where the room is, how users get in, how the alarm works, who responds to it and who to call if equipment fails.
- Add signage and information: the Changing Places symbol on the door and wayfinding, and web information on access, hours, hoist type and compatible slings.
- Register it with the Changing Places Consortium using its online form. The Consortium says registration confirms the toilet meets its standard and adds it to the map at changing-places.org. If it isn't registered, users won't know it's there.
A room with only some features (say, a bench but no hoist) won't be registered, though the Consortium may list it as an "other changing facility". Some older registered toilets have corner WCs, which don't meet the current standard, so don't copy an old layout.
Do the Changing Places regulations differ in Wales, Scotland and Northern Ireland?
Yes. Approved Document M applies in England. Scotland has its own provision (Technical Handbook clause 3.12.13) with different triggers. Wales and Northern Ireland have their own regulations, so check locally.
Scotland
The Scottish Building Standards Technical Handbook for non-domestic buildings (April 2026 edition, clause 3.12.13) says a Changing Places toilet should be provided on the construction of:
- a retail, assembly or entertainment building (or a combination of these) that is over 5,000m², has a capacity of more than 1,000 people, or contains a swimming pool;
- a hospital; or
- a secondary school providing community facilities.
Where one isn't already present, it should also be provided when a building in these categories is created by conversion, or extended so its gross floor area increases by 25% or more. The handbook sets a minimum room of 3m by 4m with a 2.4m ceiling and a door with at least 1m clear opening, and lists the equipment, including a call assistance system and, where the building has other changing facilities such as a pool, a wall-mounted shower and floor drainage.
Wales and Northern Ireland
Wales and Northern Ireland have their own building regulations and guidance. Approved Document M only applies in Wales to "excepted energy buildings". We haven't found a Changing Places requirement in Welsh or Northern Irish building regulations to quote here, so check the current position with your local building control body before you rely on it.
Related guides
Changing Places toilets: frequently asked questions
What is a Changing Places toilet?
A larger accessible toilet for people with complex and multiple impairments who may need up to two carers. It has a ceiling hoist, a height-adjustable adult changing bench, a centrally placed WC, an adjustable basin, a privacy screen and a non-slip floor.
Is a Changing Places toilet a legal requirement?
In England, Approved Document M, the statutory guidance for Part M of the Building Regulations, has expected at least one since 1 January 2021 in certain buildings that are new or undergoing a material change of use. Scotland has its own requirement.
What size does a Changing Places toilet need to be?
The Changing Places Consortium's guide and the Scottish Technical Handbook both set at least 3m by 4m (12 square metres) with a ceiling of at least 2.4m. Confirm the layout with your designer and building control body.
What capacity triggers a Changing Places toilet in England?
For assembly, recreation and entertainment buildings, 350 or more people, or 2,000 or more for a site of smaller buildings such as a zoo. Capacity is the combined total of the publicly accessible facilities, or the number of fixed seats where people normally sit.
Do shops need a Changing Places toilet?
Under Approved Document M, new retail premises of 2,500 square metres or more, and shopping centres or retail parks of 30,000 square metres or more, should have at least one. Smaller shops fall below the threshold.
Can a Changing Places toilet replace the accessible toilet?
No. Approved Document M says it should be in addition to wheelchair-accessible toilets and baby changing. Many disabled people use a standard accessible toilet and need one nearby.
Does a Changing Places toilet need a shower?
Not for registration with the Changing Places Consortium, though it recommends one in sports centres and pools. Scotland's handbook expects a shower and floor drainage where the building has other changing facilities.
How do I get a Changing Places toilet on the map?
Register it with the Changing Places Consortium using the online form on changing-places.org. It must meet the Consortium's standard, and registration adds it to the official map.
Sources
We checked the facts on this page against these sources on 11 November 2026:
- Approved Document M: access to and use of buildings (GOV.UK), Volume 2 paras 5.6 and 5.7
- Changing Places toilets: consultation and government response (GOV.UK)
- New public buildings to have Changing Places toilets for severely disabled people (GOV.UK, May 2019)
- Changing Places: a practical guide (Changing Places Consortium, 2021 update)
- Installation FAQs, hoists and changing benches (Changing Places Consortium)
- Building Standards Technical Handbook: non-domestic, April 2026, clause 3.12.13 (Scottish Government)