The short answer
Ring your council's adult social care team, or children's services for a child, and ask for an occupational therapy assessment because washing or using the toilet has become difficult. Your GP or a hospital ward can also make the referral. The assessment is free, and the therapist's report is usually what unlocks a Disabled Facilities Grant.
On this page
An occupational therapist, usually shortened to OT, is the professional who looks at how a person manages everyday tasks and works out what would make them easier and safer. For bathrooms, that means watching how someone gets in and out of the bath or shower, sits on and stands up from the toilet, and reaches the taps. Their recommendation is free, it is independent of anyone selling a bathroom, and in most of the UK it is the first step towards council funding.
Who to contact
In England and Wales, contact the adult social care department of your local council. If the person is under 18, contact children’s services instead. GOV.UK has a postcode search that takes you to the right council page for equipment and home adaptations.
You can also be referred by:
- your GP or practice nurse
- a hospital ward or discharge team, which is common after a fall or a stay in hospital
- a community physiotherapist or district nurse
- your housing association, if you rent from one
In Scotland, contact the council’s social work or adult services team. In Northern Ireland, referrals go through your local health and social care trust, which then passes a recommendation to the Housing Executive.
When you call, say plainly what has become hard. “My mother can no longer get in and out of the bath safely” or “My husband now uses a wheelchair and cannot get into the shower” is better than asking for a specific product. The OT decides the solution; your job is to describe the problem.
How long it takes
Waiting times vary widely between councils. Some see urgent cases within days; others have lists of several months for non-urgent visits. If there has been a fall, a hospital discharge is coming up, or the person is not washing at all, say so, because most councils prioritise by risk.
If the wait is long and you plan to pay yourself, you can use an independent OT. The Royal College of Occupational Therapists explains how private occupational therapy works. A private report is not always accepted for a council grant, so check with the council first if you hope to apply.
What happens at the visit
The visit usually lasts about an hour. The therapist will:
- Talk to the person about their health, what they find difficult and what help they have.
- Ask them to show how they get into the bath or shower and onto the toilet, if it is safe to do so.
- Measure the bathroom, the doorway and the space around the toilet.
- Ask about the future. If a condition is likely to progress, they will plan for that, not only for today.
It helps to have the person’s main carer there, a list of medications and any recent hospital letters. Be honest about the bad days as well as the good ones.
What they might recommend
Recommendations range from small to large:
- Equipment, such as a bath board, a shower chair or a raised toilet seat, often provided straight away.
- Minor adaptations, such as grab rails or a second stair rail. In England, councils have a duty to provide minor adaptations up to £1,000 free to people assessed as needing them.
- Major adaptations, such as replacing the bath with a level access shower, a wet room or a wider door. These go forward as a Disabled Facilities Grant application.
What the report is used for
For a grant, the OT’s recommendation tells the council that the work is “necessary and appropriate” for the disabled person. The council then checks that it is “reasonable and practicable” for the home, which is why a surveyor or the grants team may visit as well. You can read more about the next stages in our guide to disabled bathroom grants and 0% VAT.
Two things are worth knowing:
- Do not start work before approval. GOV.UK warns that you may not get a grant if building work starts before the council approves it.
- Ask for a copy of the recommendation. If you decide to pay yourself instead, it is an excellent brief for the installers you invite to quote.
If you disagree with the recommendation
You can ask the OT to explain their reasoning and to look again. Many families want a full wet room when the OT recommends a level access shower, or a walk-in bath when the OT recommends a shower. The council will normally fund only what the OT recommends, but you can top up the cost yourself to get something different, provided the council agrees it still meets the need.
When you are paying yourself
You do not need an OT to adapt your own bathroom. Many people go straight to installers who specialise in adapted bathrooms. Even so, a free council assessment often spots things a family would miss, such as the height a toilet should be, which side a rail should go, or whether a walk-in bath will really work. If you would like prices while you wait, look at what disabled bathroom installers usually charge and compare it with what the OT suggests.
What to do today
Make the call to adult social care, describe the difficulty, and ask for an occupational therapy assessment for the bathroom. Keep a copy of their recommendation: it is the brief every installer should price against.