CareHomeDeskCareHomeDeskA practical pre-scoping checklist for FMs planning a bedroom or ensuite wet room conversion -- accessibility standards, drainage and waterproofing basics, water temperature control, resident disruption, and what to put in the contractor brief.
A wet room conversion in an occupied care home is a different project from a domestic one. You are working around a resident's daily routine, within a building that may have existing structural, drainage and fire-compartmentation constraints, and against CQC's expectation that premises and equipment are suitable for the people using them (Regulation 15, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014). Before requesting quotes, establish: who the room needs to work for (mobility level, hoist use, dementia-related visual/spatial needs), whether it's a one-off adaptation or part of a wider refurbishment programme, what the existing floor structure and drainage route actually allow, and whether the resident can be decanted to another room or must remain in situ during works. Get these answers in writing before a contractor prices anything -- they change the scope substantially, and re-scoping mid-project is where budgets and timelines slip.
There is no single statutory 'wet room regulation.' What applies depends on context. Approved Document M (Access to and use of buildings) sets accessibility standards primarily for new buildings and material alterations to non-domestic buildings -- a full wet room conversion inside an existing care home may well trigger it if it counts as a material alteration, so check with your Building Control body or an access consultant rather than assuming it does or doesn't apply. BS 8300-2:2018 (Design of an accessible and inclusive built environment -- Buildings, code of practice) is the more directly relevant reference for care settings: it sets out recommended practice for accessible sanitary accommodation, including level-access shower dimensions, clear manoeuvring space for wheelchairs and hoists, grab rail positioning, and fittings mounting heights. Treat BS 8300 as the design benchmark to hand your architect or contractor, not as something CareHomeDesk verifies compliance against -- confirm current room-specific dimensions and clearances with a designer or access consultant who can assess the actual space against the current edition of the standard. What to ask a designer: does the layout give a wheelchair or hoist a clear turning/transfer space, is there a level (kerb-free) shower area, are grab rails positioned for the resident's actual transfer method (not a generic layout), and does the WC height and position match the resident's needs rather than a standard domestic install?
Wet rooms fail structurally far more often than they fail on accessibility. The floor needs a fall (gradient) to a drain sufficient to clear water without pooling, and this is genuinely difficult to retrofit into an existing timber or concrete floor without altering floor build-up, door thresholds, or ceiling height in the room below. In a suspended timber floor, forming a fall and drainage run may mean notching or dropping joists -- this is structural work and needs a structural engineer's sign-off, not just a bathroom fitter's judgement. Waterproofing ('tanking') the floor and walls before tiling is the single most common source of expensive failures (leaks into the room below, damage to the structure, mould). BS 5385-4:2015 covers the design and installation of waterproofing for showers and wet areas and is the standard a competent tiler or waterproofing specialist should be working to -- ask your contractor to confirm which tanking system they're using and that it's installed to BS 5385-4, with membrane taken up walls to the correct height and properly detailed around the drain, door threshold and any pipe penetrations. What to ask before work starts: who is doing the structural assessment of the floor, what waterproofing system and standard will be used, and will there be a leak/flood test before tiling covers the membrane? These questions should be answered in writing, not verbally on site.
Care home residents are a recognised higher-risk group for both scalding and legionella, which makes water temperature control a genuine specification requirement, not a nice-to-have. HSE guidance on managing legionella in hot and cold water systems recommends hot water is stored at 60C or higher to kill legionella bacteria, distributed hot water reaches at least 50C within one minute of running, and cold water is stored and distributed below 20C. Because 60C stored water is a scald risk, thermostatic mixing valves (TMVs) are used to blend it down to a safe outlet temperature -- this is standard practice in care settings and should be specified for any new or replaced shower, bath or basin outlet in the conversion. Ask your contractor or M&E specification to confirm TMVs are being fitted (and specified/serviced to the relevant approval scheme -- commonly referenced as TMV3 for healthcare-type applications) and that the design keeps pipe runs from the TMV to the outlet short, since HSE guidance notes temperature can drop over longer runs. This is a competent-person area: get your water hygiene/legionella risk assessment contractor to review the specification, not just the bathroom fitter.
The finishing specification is where accessibility either works in daily use or doesn't. Slip resistance of the floor covering matters more in a wet room than almost anywhere else in the building -- ask for the flooring's slip resistance rating and confirm it's suitable for a wet, barefoot-use environment, not just a general 'non-slip' claim. Grab rails should be positioned for the resident's actual transfer pattern, fixed into solid backing (not just tile and plasterboard), and load-tested to the fixing manufacturer's stated capacity. Shower seats and screens need to match how the resident actually uses the space -- a fold-down seat suits some residents, a wheeled shower chair suits others, and the two have different clearance and drainage implications. WC height and position should be set for the individual, not a standard 'accessible height' figure applied without checking. CareHomeDesk's Products library carries verified sanitaryware ranges from manufacturers including Ideal Standard, Delabie, Inta, Rada and AKW where individual product specifications and certifications can be checked directly -- use that alongside this article rather than treating either as a substitute for a site-specific specification from a contractor or access consultant.
A wet room conversion typically takes the ensuite or bathroom out of use for longer than a straightforward refit, because of drying times for waterproofing membranes and adhesives before tiling, plus first fix, floor forming, and testing. Ask a contractor for a realistic day-by-day programme, not just a headline duration, and check it against the resident's needs: can they use another bathroom nearby during works, is noise and dust manageable given cognitive needs (especially for residents living with dementia), and is there a plan for essential access (commode, hoist storage) during the work. Build in a contingency for the floor build-up issue above -- if a structural fall can't be achieved without altering the floor more than expected, the programme and cost can move significantly, and that's worth flagging as an early risk, not a mid-project surprise. Keep a simple written record of what was agreed with the resident/family and when works are scheduled -- useful both for the project file and if CQC or a relative asks about the process afterwards.
CareHomeDesk gives you compliance checklists, maintenance logs, and contractor management tools built around exactly this kind of knowledge.