Grab Rails: Ensuring a Simple Home Mod Doesn’t Go Wrong! Matthew Massy-Westropp, General Manager Steve Sheppard and Agnieszka Kuna Domiciliary Equipment Service Department for Communities and Social Inclusion

What is DES? SA government provider since 1996 of: Equipment - readily available and customised Equipment repairs, maintenance and modifications Home modifications - simple to complex Clinical support and technical expertise Central warehouse and procurement Focuses on refurbishment of 50,000 loan items = responsive and efficient What is DES?

Home Modifications 2016-17 70% of simple are CHSP funded Type Jobs Completed Time Cost Simple 3,282 16 days $1.8M Complex 84 53 days $0.1M Project Managed 68 118 days $0.6M TOTAL 3,434 - $2.5M 70% of simple are CHSP funded 82% of complex/PM are Disability funded Quotes and contracting managed by DES.

Simple Home Modifications 3,282 (96%) of all home mods 50% involve grab or bannister rails Mix of in house fabrication and installation as well as contractors May have joint site visit with clinician for more complex sites Completed within 16 days average.

If Things Go Wrong Incidents and complaints are captured directly or indirectly through agencies Technical investigations undertaken depending on severity and nature of incident Corrective actions undertaken Reporting and trends analysed

Scenario One Client fall at home 5 piece grab rail fitted in toilet User weight ~150kg Masonry wall with 10mm plaster 25mm wall plug, single fixing

Scenario Two Family discover water damage to lower ground level home Grab rail - shower kit 3 weeks prior Masonry and timber wall Copper line pierced Engineering review Drying, repairs to walls, render, tiles

Scenario Three Leak heard coming from wall cavity Rail and hose installed 4 years prior Two types of fasteners used including a nylon insert and self tapping screw Penetration to non pressure pipe Waterlogging to floor, walls, studs Damage spread to other rooms

What Needs Consideration? Person Environment Occupation

Assessing the Need Level of function of person now and in the future Demands of the home environment Expectations, goals & acceptance of change by client/ carer Least intrusive (and most cost effective) option Recommendations of Standards Home environment constraints in meeting Standards Policy of the funder

Standards vs Code Not all technical detail is contained in the National Construction Code AS1428.1 contains technical information for access: dimensions and clearances at doorways design of handrails layout of accessible toilets Taken from ABCB 2016

Grab Rail Requirements Outside diameter between 30 and 40mm (32 ideal) Radius of edges & corners of grab rails not less than 5mm Withstand force of 1100N (any direction) = approx. 110kg Clearance between rail and wall: >50mm and <60mm 600mm clearance above horizontal rail No obstruction of passage along the rail. AS1428.1 (2009) Clause 17

What About the Installation? Must consider both the material and fixings

Improving Practices Building licenses – these are task specific with none for home modifications Funder initiatives – technical manuals in use by some public housing programs Training for assessors to understand context and application of AS in the home Training for building industry – home mods may be seen as nuisance work.

Thank You! Phone: 1300 295 786 Repairs: 1300 130 302 Email: des.frontdesk@sa.gov.au Catalogue: www.des.domcare.sa.gov.au Web: www.des.sa.gov.au