Stair safety

Falls in general are the largest cause of emergency hospital admissions for older people and significantly impact on long-term outcomes, e.g. being a major precipitant of people moving from their own home to long-term nursing or residential care.

Falls on the stairs can be caused by a combination of environmental and personal factors - for example the state of the stair covering or clutter left on the stairs, a person’s sight or their medication affecting balance.

You can help your own or another person’s safety by making sure that:

• you move carefully and slowly on the stairs
• you do not get distracted when using the stairs
• you avoid using the stairs if you feel unwell, dizzy or faint
• you wear well-fitting shoes
• if you have to carry something, you keep one hand free to hold the handrail, you keep the stairway well lit with a light switch at the top and bottom of the stairs, you remove any loose rugs at the top or bottom of the stairs
• you have secure handrails at an appropriate height on both sides, ideally that contrast with the surroundings
• you keep the stairs clear of clutter or obstacles
• you keep stair covering in good condition.

It has been shown that an accident is more likely to occur on stairs without a carpet covering, and those with no handrails or guardrails. It has also been demonstrated that a very decorative stair covering can make seeing each step more difficult, especially for those with poor eye sight.

It is recommended that you have a stair covering with good slip resistance properties and that you consider highlighting the edges of each step for those with poor sight.

If you use a walking aid, consider having one upstairs and one downstairs, to avoid carrying the aid up and downstairs. If you need the walking stick to help you get up and down the stairs, ask for a physiotherapist to show you how to do this properly and safely.

Stair rails

Grab rails for isolated steps
If you have places in the home where you have one or two steps, try installing a grab rail either side of these steps to give you something to hold onto as you go up and down. Fit the rail at the approximate height of your wrist when standing on the first tread, with your arm relaxed by your side. You are advised to install grab rails long enough to extend just past the top and bottom ends of the steps to provide a steady anchor/pulling point.

Long handrails
Staircases usually have a handrail on one side, although this may not extend to the full length of the staircase. It is recommended that you extend the handrail past the top and bottom of the stairs to provide a steady anchor/pulling point. Most DIY stores sell handrails which can be used to extend the existing handrail all the way up the staircase if it is required. Adding a handrail to the other side of the staircase will provide more support where needed. Long lengths of rail are available and may also be installed along corridors.

A wide range of finished hand rails are available from DIY chains for you to choose from. A plain 50mm mop head cross section softwood rail may be used.

It is recommended that it is run continuously from the bottom to the top of your flight of stairs, including going around the edge of any intervening landings and across window openings. The handrail should continue past the top and bottom steps by at least 300mm.

The height will depend on your needs. If on both sides, the rails should be at the same height. This is usually between 900-1000mm above the pitch line of the stairs

The handrail should have a fixing at least every 1000mm and no more than 150mm from each end. It may require mounting on a pattress or backboard which is then secured to the wall.

Newel rails

Newel rails are designed to turn through 90 degrees around the newel post (the upright post of the stair banister).

They provide a continuous grip as the user reaches the bottom or top of the stairs and turns the corner and are available in a range of sizes.

Please note that left turning and right turning Newel rails are available - which one you require depends on which way your staircase turns after the newel post.

Stair rails which move with you
 

With this design a rail is fixed securely to the wall, with a bar which folds down in front of you and moves up and down the rail when pushed as you use the stairs. As soon as a sudden weight is applied to the bar, it locks to steady the user.

The bar can be folded away when not in use.

This design gives stability and a sense of security to the user. You still need to be able to walk up and down the stairs and have a reasonable grip.

Stairlifts

Stairlifts are powered lifts mounted on wall or stair-fixed tracks which follow the line of the stairs. Straight and curved tracks are available to cater for the various shapes of staircases. Straight tracked stairlifts are significantly cheaper than curved ones. Stairlifts are usually cheaper to install than through floor lifts, as building alterations are not normally required. Stairlifts can usually be installed in a day and can be removed if no longer required.

There are a range of designs of stairlifts, including:

• those with a seat
• those upon which you stand or perch
• those with a wheelchair platform.

For each, you need to be able to get on and off the lift, to remain secure whilst on it and to be able to use the controls - unless a carer is controlling the lift for you.

Unless you are using a lift with a wheelchair platform, you will need to have reasonable body strength and stability, plus a reasonable grip, to remain safely in the lift whilst in use, especially if perching or standing. A stairlift may not be suitable for you if you experience severe uncontrollable body movements or dizziness, as this could cause you to fall from the lift. It may also not be suitable for someone with reduced cognitive ability, who may be made anxious and try to get off the lift whilst in use.

A stairlift may not be suitable for you if you are very heavy. The lifts have specific weight capacities, which are lower if the lift has to go around corners. The maximum weight limit for a standard heavy duty stairlift is generally 25 stone (160kg). Those with greater capacity may only cater for straight stairs.

It is advisable that the stairlift covers the whole staircase. If your staircase has a sub-landing at the top, with a few steps to the left or right, some companies may suggest fitting a manual or motorised folding platform which bridges the gap between the top of the stairlift and the landing. This can lead to problems, e.g. if the platform is down and someone else tries to walk up the stairs.

If you have a staircase consisting of two straight flights of stairs with a landing area between them, it may be cheaper to purchase two straight stairlifts instead of a curved one, as long as you can transfer between them.

Walking sticks may usually be carried on a stairlift with care. If you use a larger walking aid, it should not be carried on the stairlift. Two aids will be required - one at the bottom and one at the top of the stairs.

Seated stairlifts

These tend to be the most common type of stairlift used in a domestic setting. They transport you up and down the stairs whilst seated, suiting those with reduced mobility and/or standing tolerance.

A minimum staircase width of about 750mm (29") is required by most individuals if they are to use a stairlift safely and in comfort.

To see if you will have enough room for a stairlift, place a chair at the very bottom of your stairs, with the chair back against the wall. Sit yourself on the chair, with your bottom as far back on the seat as you comfortably can. You can then see how much space you will have for your feet and knees if you have a stairlift installed. Most seats face sideways, but if you have a stiff knee, or a narrow staircase, you may need to face forwards to give you more room. Check with your supplier, as some stairlifts are available with seats which face forwards. If you find it difficult to bend your knees, making your feet stick out, you may prefer to look at a perching or standing stairlift.

Other members of the household should be able to use the stairway when the lift is folded against the wall in most cases. It may be more difficult if you have a very narrow staircase.

Some companies recommend that you infill, or board up banisters/spindles on the staircase, to prevent your feet getting caught between them as you go up/down the stairs. This may depend on how much clearance your staircase gives you.

Standing and perching stairlifts

These can be used if you are able to walk to the stairlift and stand while travelling up and down stairs. These may be chosen in preference to seated models if the staircase is exceptionally narrow or if you have a stiff leg or legs and are unable to bend your knee/s when seated. A standing or seated stairlift would not be suitable for you if you experience severe uncontrollable body movements or dizziness, as this could cause you to fall from the lift. It may also not be suitable for someone with reduced cognitive ability, who may be made anxious and try to get off the lift whilst in use.

Standing stairlifts require you to fully weight bear whilst standing as the stairlift makes its way up/downstairs, so may not be ideal if you have reduced standing tolerance or tire quickly. On most models you stand sideways on to the stairs, but some require you to stand facing down the stairs. If facing sideways, these stairlifts usually have support on either side, similar to the armrests on a seated stairlift, with an additional guard rail on the lower side of the lift. If facing down the stairs, there is a strong guard rail to grip in front of you.

Perching stairlifts are very similar to standing stairlifts, except that they provide a small amount of additional support underneath the buttocks. You will travel in a perched position, i.e. between sitting and standing. As with standing stairlifts, there is usually support either side, similar to the armrests on a seated stairlift, with an additional guard rail on the lower side of the lift.

If you are selecting a standing or perching lift, ensure there is adequate headroom from top to bottom of the stairs.

Stairlifts with a wheelchair platform

These eliminate the need to transfer out of a wheelchair and onto a stairlift. Instead you wheel, or are pushed, straight onto the platform.

Although most of the platforms fold up against the wall when they are not in use, this type of stairlift takes up a lot of room on the stairs and many domestic stairs are not wide enough to accommodate them.

Outdoor stairlifts

Outdoor stairlifts have the same features as a standard indoor model, with a swivel foldaway seat, key switch control, safety sensors, seatbelt, etc, but they are designed to work in all weathers. A cover is usually available to place over the seat when not in use.

An electricity supply is required and must meet installation safety requirements.

Second hand stairlifts

It is possible to save some money by buying a second hand stairlift. It is advisable to purchase from a stairlift manufacturer, or an authorised company dealing in re-conditioned stairlifts who will have checked that the stairlift meets current safety standards, and will provide a warranty.

The tracking for straight stairlifts can usually be re-sited. The track of a second hand curved stairlift cannot be re-sited in another house. However, with some makes, a new track can be made to fit your house and the second hand seat unit and motor can be used in conjunction with it.

If you are considering buying a second hand stairlift privately, e.g. via the local paper or adverts board, it is advisable to get the original stairlift manufacturer, or company dealing in re-conditioned stairlifts, to assess the stairlift for its suitability for your use in the new location, service it, and, if all is satisfactory, actually carry out the installation. You should not attempt to wire up and install it yourself. Always check that the manufacturer is still in business and/or parts are still available should anything go wrong.

Once the stairlift has been installed, it is advisable to set up a service/maintenance contract with a company who you will be able to call on when required if mechanical difficulties arise. Annual maintenance is recommended.

Rented stairlifts

A number of companies offer stairlifts for rent and/or hire, usually charging an initial fee for installation and then a regular monthly sum. Check with the company what the minimum rent/hire period is. These rental stairlifts are often pre-used, so your choice of colour and style may be limited. Hiring may be ideal if you are recovering from an accident or operation and do not want a permanent installation.

It may be a good idea to look for companies that are members of the British Healthcare Trades Association (BHTA) and/or LEIA (Lift and Escalator Industry Association (LEIA) whose members have signed up to a code of practice governing standards of customer service.

Stairlift features

Rechargeable batteries
Most stairlifts have rechargeable batteries that are usually topped up from charging points at the top and/or the bottom of the stairs. Thus they will operate if there is a power failure. The chair requires re-siting at the charging point when not in use and will give a warning bleep if it is in the wrong place. Batteries will eventually need replacing, but should last three-four years. It is essential that the power supply is always connected to enable regular recharging.

Remote controls or 'Call Stations'
A call station is a remote control unit located away from the chair of the stairlift. They are usually sited at the top and bottom of the staircase so a user can 'call' or control the stairlift. This allows users to bring the stairlift to them at the top or bottom of the stairs so they can get on it, or a carer may use the remote control to operate the stairlift for the user.

Control switches
There is a range of designs of control switches incorporated into the end of the armrests on a seated/perching stairlift. This includes standard joysticks, ergonomic joysticks which require less pressure, rocker switches and paddle switches. If you have difficulty in using your hands, you may find that one particular design suits you better than another. Ask your supplier what options are available to try. If you need the controls sited in a particular place for you, ask if this is possible.

Audible signals
For those who are blind or have sight loss, lifts are available with an audible signal to indicate that the lift is at the top or the bottom of the track.

Height adjustable backrest
Some seated stairlifts offer the option of a height adjustable backrest, similar to a desk chair. This may be most useful if you are very tall and need good support at the right height behind you.

Height adjustable and swivel seat
Some seated stairlifts offer adjustable height seats. Having a suitable height chair can help you to sit down and stand up more easily and safely when using the stairlift. If you are transferring from a wheelchair it is easier if the surface from/to which you are moving is adjusted to the same height.

Most seats can swivel at the top and bottom of the stairs, allowing easier access when you are getting on/off. You can choose between manual and powered swivel seats. With manual seats you need to turn the seat yourself by twisting your body in the same way you turn while seated in a standard office chair. With a powered seat swivel you maintain pressure on the lever or switch which operates the stairlift and the seat is turned automatically by electric motors. Check that you will be able to operate the seat swivel mechanism before you buy. For safety the seat should always be locked in position before sitting or standing from it, regardless of whether the swivel is manual or powered.

Moulded seating systems
It is possible to use custom-made moulded seating systems with a stairlift, but you will need specialist advice to do so. The seat, with the user in it, would still have to fit within the dimensions of the stairway. Moulded seating systems may need to be removed before the underlying framework can be folded away.

Folding the seat up and out of the way
The seat, armrests and footrest on a stairlift can usually be lifted up and out of the way when not in use. Some people struggle with folding the footrest up manually. Some stairlift models have a link between the footrest and the seat or the arms of the lift - when you raise the arm or seat the footrest folds up as well. This avoids the need for you to bend, but does require some strength to lift. If this is too difficult then there are models with powered footrest raisers that will raise the footrest at the touch of a button, or when a little pressure is applied to raise the stairlift's arms or seat.

Safety belt
Most safety belts are in the form of a lap strap. Some are retractable, so do not get in the way when not in use. A diagonal lap strap (like a car seat belt) or a full five point body harness can be provided by some manufacturers on request.

On/off key switch
The on/off key switch is usually located on the armrest or main body of the chair. When the key is removed the stairlift is completely immobilised. This is a useful safety feature if, for example, there are small children in the household who may try and operate the stairlift.

Safety sensors
Safety sensors can be positioned on the footrest, chair or rail. They automatically stop the stair lift if they sense that something is in the way whilst moving up/down the stairs.

Status display
Some chairs have a small digital display which states the current status of the stairlift. Should a fault occur, it would be displayed as a diagnostic code in the display.

Hinged rail
On stairlifts with a hinged rail, the bottom section of the rail folds upwards and out of the way to prevent it causing an obstruction or tripping hazard. This may be essential if there is a doorway in the wall at the bottom of your stairs. Consider whether you will be able to fold the rail manually or if you require a motorised folding rail/powered hinge.

Emergency stop
All stairlifts will have an emergency stop button/control, usually on both the chair and the remote/wall-mounted control unit.

Emergency manual control/winder
The chair will also have a manual winding mechanism for use in emergencies, should the motor fail. This is usually a circular handle, inserted into the main body of the chair which needs to be manually turned in order to move/wind the chair.

Vertical/through-floor lifts

Vertical, or through-floor lifts, may maximise your independence by enabling you to move from one floor to another within your home or a public building. If you use a wheelchair you can avoid the need to transfer in/out of your chair.

However, vertical lifts need more space than a stairlift, both at the ground floor/lower level and in the room at the top. It will require some alteration work to your property. You do not usually need planning permission, just a standard building notice application. This will be different if you live in a listed building. 

It is essential that the lifts are installed by a qualified engineer, that regular maintenance is carried out, and that lifts are inspected and tested every six months by a qualified lift engineer.
 

Considerations when choosing a vertical/through-floor lift

When choosing a vertical/through-floor lift, consider the following:

• For wheelchair passengers the lift car or platform should have a level or ramped access. If you use a self-propelling wheelchair you should make sure that you can open the lift door easily. Some lifts have doors that can be opened using push button controls
• For seated passengers there is a choice of fixed seats, fold-down seats, perching seats and seats which slide forward to assist access in and out of the lift. Some companies will fix the seat at the most appropriate height for the user.
• Dimensions and house design considerations - it is important that there is enough space for you to approach and enter the lift easily. Most lifts are accessed from the front of the car but some companies are able to offer side door entry.
• Most lifts have push button controls sited within the car. Additional remote handsets may also be available. Some companies offer alternative control mechanisms and some can position the controls to suit the user. Illuminated controls are available and may be particularly helpful for users with low vision.
• How might your ability to use the lift change over time? Can the lift be managed by a carer if required?
• Are there any risk factors for you or others when using the lift? If you experience seizures, what would you do if this occurred whilst you were in the lift?

Safety features

Check the following safety features when choosing a through-floor lift, many should be included as standard:

• a system for controlling the speed of the lift, with an emergency stopping system
• emergency lowering via a wind-down handle or a battery operated/hydraulic back-up system, should there be a power failure
• an automatic door locking mechanism when the door shuts
• an on/off key switch
• sensors underneath the car to detect any objects that could possibly block its path, e.g. toys
• The 2012 British Standard for through floor lifts and home lifts have strict requirements for fire protection. These must be adhered to when installing through floor lifts. Ensure that you ask the supplier or manufacturer how the model you choose meets these standards
• an in-car alarm or telephone to call for help.

Vertical lifts without a shaft

Vertical lifts without a shaft are commonly used in home environments as they require less structural alterations than lifts with a shaft. Although versions are available that carry a seated or standing passenger, most are used by wheelchair users. The lift car is either partially or fully enclosed and usually travels up and down wall-fixed tracks. Partially enclosed cars let you see outside and may be more suitable if you do not like enclosed spaces. The doors on totally or partially enclosed carriages are electronically interlocked as a safety precaution so that they cannot be opened when the lift is moving, and the lift will not move if the door is open.

In order to travel between floors a trap door or aperture is constructed in the ceiling/floor which automatically opens and closes. When the lift is on the ground floor the gap in the ceiling is covered by an infill that matches the ceiling of the room, whilst when on the upper level the infill blends in with the flooring of that room.

Vertical lifts with a shaft

Lifts for use in any nursing, residential or public building must be enclosed within a shaft and usually require extensive structural alterations. They can carry more than one person at a time, either someone standing, someone in a wheelchair or both. They can be accessed via a ramp or recessed into a shallow pit for level access.

Short rise lifts - fixed and mobile

Short rise lifts - fixed and mobile

Short rise lifts can be used indoors or outdoors where a change in level occurs, e.g. at a front step or in a split level hallway. They are particularly useful in confined spaces where installation of a ramp is not possible. They may make it possible for individuals using a wheelchair to independently propel directly onto the platform and move between levels without assistance. Some short rise lifts are able to carry both the wheelchair user and carer. Fixed short rise lifts may require structural alterations before installation.

To provide level access, the mechanism of many fixed models has to be sunk below ground level in a pit so that the platform is flush with the ground at its lowest position. Where this is not possible, ramped access to the platform will be necessary. Most platforms lift vertically so are situated next to, or instead of, steps. Others may have a bridging mechanism that lifts the platform up and over the steps. When the lift is not in use the steps can be used in the normal way. New designs are emerging which convert the steps into a lift platform.

Look at the features on the lifts you are considering:

• Can you manage the controls or are remote controls an option?
• Are there side support rails if you need them?
• What is the back-up mechanism should there be a power failure?

Mobile short rise lifts/portable lifting platforms do not require structural alterations.

They may be useful for overcoming a small change in level which does not need to be accessed very often, e.g. into the garden or on to a stage.

The lifts may be operated manually or electronically, powered by a rechargeable battery, and are accessed via a ramp. The ramp then folds up whilst the lift is in use. Some enable a carer to travel with the wheelchair user.

Check how easy it is to move the lift. Those with larger wheels may be easier to transport.

Stairclimbers

These are operated by a carer and are designed to climb up and down a flight of stairs with you sat on the device. Some people can find it makes them feel uneasy facing down the stairs with no control over their own movement. As these climbers are not attached to the staircase they can be transported and used on different staircases. They are available either as a seated device into which you transfer or as an attachment that fits onto a standard manual or powered wheelchair. Some have caterpillar tracks that grip the stairs and others have a wheel cluster which rotates as you go up or down. They are powered by a rechargeable battery.

Some of the stairclimbers with an attachment onto which a wheelchair can be attached require the wheelchair's rear wheels to be removed when going up and down stairs. These are only suitable for wheelchairs with quick release wheels and a carer /attendant who is confident to remove and re-attach the wheels.

It is essential that your carer is familiar with, and has been trained on using, the equipment before trying to operate it. It is important to consider the staircase, as stairclimbers will only cover a certain depth of tread and only some types of stairclimber can manage curved staircases. In public buildings carer operated mobile stairlifts can be used for emergency evacuation if approval is obtained from relevant safety officers.

Arranging quotations

If you intend to purchase privately consider the following tips:

• Always obtain more than one quote. Try to obtain quotes from both a manufacturer and a local supplier for a comparison
• When arranging a quotation, confirm with the company that you will not need to pay for the quotation.
• Ask for brochures to be posted to you and read them, know what you're buying, and prepare a list of questions. Read about the features available and prioritise what is most important to you
• Confirm with the company that they are the approved distributors for the stairlift/lift that they are selling and that they are able to supply spare parts
• Ask who will look after your lift if it breaks down? Are there any maintenance costs, and is there an expensive ongoing contract? What are the company's response times? All lifts should have a 12 month warranty but ask about the terms and conditions. You may have to pay extra for 24-hour call-out cover.
• Ask how many engineers the company has in your area
• Arrange to have an occupational therapist present during the visit. If this is not possible, ask a trusted friend or family member to be present instead
• If possible try a stairlift/lift out in an equipment demonstration centre, or a showroom or in the house of someone who already has one fitted.
• Beware of hard sale techniques. Ignore special offers, which only apply if you 'buy now'. Some salespeople start by quoting a high price and then offer discounts to close the sale. A reputable company will quote the best price from the start. Do not feel pressurised into signing up during the visit
• Ask if the company has a buy back policy and, if so, get it confirmed in writing
• If you do have to pay a deposit, ask for the company's cancellation policy in writing.

Installation of rails

Grab rails are only as strong as the wall to which they are fixed to, and the fixings that are used. Unfortunately many modern houses, which were built as cost-effective, thermally efficient buildings, do not have internal walls that are ideal for the installation of wall fixtures such as support rails.

If you are unsure about fixing rails in your home, you are advised to seek advice.

Traditional bricks and concrete blocks
Good quality traditional masonry and bricks should cause no problems if the recommended fixtures and procedures are followed. A plasterboard or tiled surface should not affect the fixing, although ensure that the whole depth of the fixing is supported by the masonry.

Most dense concrete blocks are strong enough to support rails. However, care should be taken as their composition may make it difficult to drill a straight hole through them.

Lightweight aerated and hollow bricks
If the wall is made of lightweight, aerated and hollow brickwork, even the most appropriate fixings may not be able to withstand the loads which can be suddenly applied to rails and hinged arm supports.

The insides of the hollow blocks are often filled with a polystyrene type insulating material which will not provide enough support for fixtures screwed into it.

Similarly, aerated concrete blocks, which are often used in bathrooms and toilets as the waste pipes are carried through their cavities, are made of a very lightweight substance which limits their fixing support qualities. Supporting fixtures should be attached to this type of wall using specific wall mounted support products or battens.

Partition and stud walls
Even if a partition or stud wall is physically strong and stable and has a suitable flat surface to take a grab rail, the addition of a pattress or backboard on the wall is advised when fixing a grab rail to it.

This should be a flat, unknotted piece of wood, which is screwed into the vertical joining pieces of the partitions. The grab rails can then be attached to the board. The Royal College of Occupational Therapists recommends a 144mm x 19mm board/pattress with its external corners well rounded and the board itself fixed to the wall at least every 900mm.

Particular care should be taken when attaching rails to domestic sandwich partitions, e.g. plasterboard with a hardboard facing.

Fixing to UPVC plastic door frames should be avoided as the frames are unlikely to have the necessary internal materials in the required area to support a grab rail's fixings.

In many areas local authorities or Age UK run a handyman scheme. For a small charge, this scheme may be able to assist with small jobs such as fitting grab rails, spy holes in your door, replacing tap washers, and fitting smoke alarms or telephone extensions.

Electrics and grab rails
When installing a grab rail the installer should ensure there is no possibility that any metal part which may be touched by you, including fixing screws, will come into contact with electric cabling. They should follow British Standard BS 7671 Requirements for Electrical Installations. IET Wiring Regulations.

Service and maintenance

Most major companies provide a one or two year warranty with the lifts/stairlifts, which you may be able to extend if wanted for a charge. The lift/stairlift mechanism is a complicated piece of equipment and is subject to a great deal of wear and tear. It is essential that regular maintenance is carried out and that lifts/stairlifts are inspected regularly by a qualified lift/stairlift engineer. It is recommended that they are inspected every six months and serviced annually.

Some companies offer an emergency call-out service. However, check that they have fully trained service engineers on call in your area. It is advisable to check what is covered by your warranty (spare parts for example) and what ongoing expenses might be before purchasing.

British Standards

BS EN 81-40:2008 (BSI 2009) defines the current safety rules for the construction and installation of lifts, special lifts for the transport of persons and goods and stairlifts and inclined lifting platforms intended for persons with impaired mobility.

BS EN 81-41:2010 (BSI 2011) defines the safety rules for the construction and installation of lifts. Special lifts for the transport of persons and goods and vertical lifting platforms intended for use by persons with impaired mobility.

BS 5900:2012 (BSI 2012) specifies requirements for the design, manufacture, installation, commissioning, testing, maintenance and dismantling of new permanently installed electrically powered homelifts. It is applicable to homelifts that are installed in private dwellings and are intended for the transport of persons with impaired mobility, standing or seated, with or without a wheelchair.

Lift and Escalator Industry Association (LEIA)

LEIA is the trade association and advisory body for the lift and escalator industry. It has collaborated with the British Standards Institution (BSI) to produce recommendations for best practice in the sales, installation and aftercare of personal lifting products. Members sign up to a Code of Practice for Personal Lifting Equipment. This incorporates measures directed at the removal or easing of consumer concerns and undesirable trade practices arising within the personal lifting equipment sectors of the lift and escalator business. 

Identifying your needs

There are a number of factors about yourself to consider in order to identify the most helpful equipment or adaptations for you. For example, how able and stable are you when you:

• mobilise (walk or propel yourself in a wheelchair)
• transfer (move your body from one location or surface to another)
• sit and stand unsupported, or supported
• grip with your hands
• support your bodyweight on one leg, even for a very short period
• step up or step down.

A physiotherapist would be able to assess your level of mobility on the stairs and give you some advice about how to manage safely. To be referred to an NHS physiotherapist, speak to your GP or other health professional. Alternatively, to find a local private physiotherapist, visit the The Chartered Society of Physiotherapy's website. If you are unable to walk, or if you need support to maintain a seated position, you may want to consider a lift that can accommodate you and a wheelchair, such as a wheelchair stairlift, or through floor lift. If you are unable to walk, but are independent in transfers from a wheelchair to another surface, you may be able to use certain stairlifts if they can be sited to enable you to transfer on/off them safely. If you cannot transfer on/off the seat independently seek expert advice as assisted transfers at the top of the stairs could be very dangerous and should be avoided.

If you are still able to walk but need additional support, consider your ability to grip onto a grab rail. Do you have reasonable hand strength? Do you ever have pain in your hands, wrists, elbows or shoulders which would prevent you from pulling up or pushing down on a grab rail? Look through the information in this sheet about installing additional rails to assist you on the stairs. If you are very unstable when standing and you find it difficult to bear your own weight, grab rails may not be the most suitable answer for you.

Climbing the stairs is very tiring. You may want to consider installing equipment which will reduce the strain and effort, such as a stairlift, allowing you to use your energy for other, more enjoyable, activities. You may also want to take into account your future needs. Will any condition you may have, or the effect of aging, increase your need for assistance in the future? If so, it may be worth considering installing a lift now, so future-proofing your home.

If you are a very large person you must consider the weight limitations of any equipment or adaptations that you install. Weigh yourself accurately and check the manufacturer’s advice on all equipment. If you are very tall, you may also need to check the clearance needed for your knees and feet if you are travelling around a tight corner on the stairs in a seated position.

If you are unsure about the best way to maintain your safety and independence on the stairs, you are advised to seek a formal assessment of your needs from your local authority social services department, or from a private/independent occupational therapist.

Health and social care needs assessment

If you are struggling with caring for yourself, or your carer is struggling to provide care for you, consider asking for a health and social care needs assessment from your local authority. This includes an assessment of any physical difficulties you may be experiencing, such as your ability to access the areas of your home that you need to in order to care for yourself, or any risks such as using the stairs.

Under the Care Act 2014, anyone who appears to need care and support can request an assessment from their local council, irrespective of their income or savings. The Act places a statutory duty on local authorities and the NHS to support individuals to take steps to prevent their ill health or care requirements from getting worse. These strategies for prevention can include the early provision of equipment and services to help prevent, delay or reduce the development of further need for care and support, which would include the provision and fitting of grab rails depending on the cost.

The care and support assessment aims to identify any difficulties you may having in caring for yourself and how this impacts upon your wellbeing. If you have someone who helps you, they can have a carer's assessment to see if they also need support to continue in their caring role.

Funding sources

The cost of a stairlift is mainly dependent upon the shape of the staircase. A simple straight stairlift can be bought for around £2,000. Prices rise to as much as £6,000, or more, if you have curved or especially long stairs, or need additional features. A survey carried out by Which? in 2016 revealed that the average price paid for a stairlift was £3,475.

Statutory direct payment, personal budgets and prescriptions

You may be provided with equipment and services as a preventative measure, before a needs assessment is done. As stated above, you would not pay for this below £1000. If, on assessment, your needs are high enough to qualify for further help from the council, they will then look at your income and savings to see whether you will need to pay towards any future services you receive. These services might include further disability equipment or adaptations to your home, help from a carer, telecare, the delivery of meals or residential care.

If you are provided with direct payments or a personal budget from the council, you can pay for equipment and other one-off purchases, so long as they have been identified as needed in your health and social care assessment.

In many areas a range of the simple aids to daily living may be available on prescription, issued by the assessor. If you receive a prescription for equipment you can take it to a local accredited retailer, which may be a local pharmacy, who will provide you with the item. You can pay extra for an alternative item, so long as it does what the specific item prescribed would do. Your choice may offer extra features, or perhaps you prefer its appearance. There is usually a list of accredited fitters available for items like grab rails.

If you are unsure about obtaining and fitting equipment or adaptations, seek advice from your council. They should be able to provide you with information and advice about services or resources which could help you.

Disabled Facilities Grants (DFGs)

A local authority Disabled Facilities Grant, often referred to as a DFG, may be available for essential home adaptations for you as a disabled person, if they are deemed ‘necessary to meet your needs’ and the work is ‘reasonable and practical’. This can include extensions and structural work to accommodate fixed hoists, stairlifts, downstairs bathrooms, shower units etc. If this type of adaptation is needed, a local occupational therapist will come to assess your needs and then contact the relevant council departments. The occupational therapist’s recommendations are taken as evidence that the work proposed is appropriate and meets all the requirements for funding.

The occupational therapist will be able to explain the application process. Information is also available from your local authority and on the Government website.

DFGs operate across England, Wales and Northern Ireland. Local authority funding for minor adaptations (which would include grab rails) varies slightly across the United Kingdom. In England, if you are assessed as eligible for preventative intervention, items like grab rails under £1,000 would be free of charge to you. If the proposed equipment or adaptations were more than £1,000, you may have to apply for a Disabled Facilities Grant.

For details of schemes in Scotland see Disability Information Scotland and Scottish Government (2009) Help with adaptations to your home: A guide for disabled people in private housing in Scotland. Edinburgh: Scottish Government.

Please note that you may not receive any grant if you start work on your property before the council approves your application.

Private purchase

If you decide to buy equipment privately it is best to compare the different ranges of equipment first. You may have an equipment demonstration centre near you where you can view and try out different equipment and receive impartial advice to help choose appropriately.

Look for a sales company that belongs to a trade association, such as the British Healthcare Trades Association (BHTA). BHTA members have signed up to a code of practice governing standards of customer service.

Charity and grant funding

Charitable trusts may sometimes provide funding for equipment. Charities tend to give awards in accordance with a predetermined criteria, so it is important that you carefully select the organisations that you apply to.

VAT relief

If you have a diagnosed long term condition, you may be able to claim VAT relief on the purchases, thus reducing the cost. Ask the supplying company or check their website for further information.