Cerebral palsy can affect almost every part of a child’s daily life. As a child grows, their family may find that the layout of their home no longer allows their child to move around safely, use essential equipment or take part in everyday activities as independently as possible.

Home adaptations and equipment to support a child and adult with cerebral palsy can make a significant difference to their life. However, some homes cannot accommodate the changes a child needs and the required adaptations and space for equipment as well as for carers and therapy to take place. In these circumstances, the family will need to move to a more suitable property.

Where medical negligence caused or materially contributed to a child’s cerebral palsy, compensation is likely include funding for adaptations and appropriate long-term accommodation. In this guide, we explain how housing needs are assessed and how the right environment can support a child throughout their life.

Why Might a Child with Cerebral Palsy Need Home Adaptations?

Cerebral palsy affects people in different ways. Some children and adults can walk independently or with mobility aids, while others use manual or powered wheelchairs. A child and adult may also need adaptive equipment to support their posture, communication, personal care and everyday tasks.

The family home may need to provide enough space for:

• Wheelchairs and other mobility equipment, as well as storage and charging facilities 
• Walking aids and standing frames
• Hoists and transfer equipment
• Specialist beds and seating
• Communication devices and assistive technology
• Carers (including space for accommodation for night carers), therapists and healthcare professionals
• Therapy or rehabilitation activities
• Sensory facilities such as sensory rooms/equipment
• Hydrotherapy equipment and potentially a pool
• Space for suitable outdoor equipment
• Space for a wheelchair accessible vehicle to be parked and space for additional vehicles for carers/therapists

A property that was suitable when the child was very young may become less practical as they grow. Equipment becomes larger, transfers can require more support, and parents may no longer be able to carry their child safely.

Appropriate adaptations or alternative accommodation is designed to encourage independence, improve safety and reduce the physical demands placed on the child and their carers.

Ramps and Level Access

A permanent ramp or level-access entrance can make it easier for a child with cerebral palsy to enter and leave their home, especially for those who use wheelchairs and walking aids. It can also help parents and carers move mobility equipment without needing to lift it over steps.

The design needs to account for the space available, the gradient and the child’s current and future mobility. There should also be enough room for a wheelchair to turn safely near the entrance should a wheelchair be required.

External paths, gates and parking areas are likely to need adaptation too. A family will usually require off-road parking close to the entrance, particularly when the child uses a wheelchair-accessible vehicle or needs additional assistance when transferring.

Widened Doorways and Accessible Hallways

Widening doorways will be required to allow a child using a wheelchair or other walking aids to move more easily between rooms, as standard measurement doorways in properties will not provide enough space for wheelchairs or other assistive devices to manoeuvre through.

Hallways may also need to be widened or reorganised so that wheelchair users can turn without hitting walls, doors or furniture.

The flooring should support safe and comfortable movement. Loose rugs, raised thresholds and uneven surfaces can create unnecessary obstacles for children with reduced balance or stability. The flooring also needs to be compatible to wheelchair use if this is what the child and adult will be using to move around the home. 

Adapted Bathrooms and Personal Care

Bathrooms also have to be carefully considered in terms of suitable adaptation and provision to meet the child and adult’s needs. This will need to provide enough room for a wheelchair, carers or specialist equipment. Depending on the child’s needs and their needs as an adult, a bathroom will need suitable bathing and toilet facilities and space for recommended equipment and carers.

An adapted bathroom may include:

• A level-access shower
• A shower chair or specialist seating
• A height-adjustable sink
• Support rails
• A specialist toilet
• Non-slip flooring
• A ceiling-track hoist
• Space for carers to provide support

The child may also need equipment that supports stability, posture and safe transfers. Occupational therapists will assess how the bathroom should be designed around the child’s ability and personal care needs.

Bedrooms, Hoists and Specialist Equipment

A child’s bedroom will often need to accommodate much more than a bed and storage.

Depending on their needs, the room may require:

• A specialist or height-adjustable bed
• Space for a wheelchair and mobility equipment
• A ceiling-track hoist
• Positioning equipment
• Communication devices
• Charging points for powered equipment
• A suitable space for overnight carers, including carer accommodation, depending on whether this requires waking/sleeping night care

The bedroom should provide enough room to transfer safely between the bed, a wheelchair should this be being used, and other adaptive equipment.

Some children also use ankle foot orthoses, ankle braces or shoe inserts to support their movement and positioning. Suitable storage will be needed for these items, as well as for standing frames and other mobility aids.

Where a child requires care during the night, a separate bedroom and living space may be needed for an overnight carer(s).

Kitchens and Shared Living Areas

Adaptations should not be limited to essential personal care. Children and adults with cerebral palsy should also be able to participate in family life where possible.

An adapted kitchen may include:

• Height-adjustable work surfaces
• Accessible storage
• Space beneath counters for a wheelchair
• Easy-to-use handles and controls
• Non-slip surfaces
• Adaptive tools and utensils

Children with reduced hand function, grip strength or fine motor skills may use adaptive utensils with larger handles, non-slip plates or other equipment that helps them eat more independently.

Living areas should have enough space for wheelchairs and assistive devices without making the child feel separated from the rest of the family. Specialist design can allow them to take part in meals, play and other daily tasks.

Some children may also use hearing technology, including hearing aids or cochlear implants, alongside communication devices. The layout of shared spaces should make it easier for them to see, hear and communicate with family members.

Assistive technology may also allow users to control lights, doors, curtains, televisions and other appliances. Eye tracking technology, adapted switches or voice controls can give some children greater independence within the home.

Therapy and Development at Home

Children with cerebral palsy may receive physiotherapy, occupational therapy or speech and language therapy. Their healthcare providers may recommend exercises and activities that can be practised at home alongside formal sessions.

A physiotherapist may suggest exercises to assist children in improving their body strength, balance and movement. A speech and language therapist may help children develop communication and language skills. This may include using communication boards, writing aids, communication devices or sign language.

The property may therefore need enough space for:

• Stretching and movement exercises to build strength, flexibility and balance
• Standing frames that support the child in an upright position
• Any other specialist mobility equipment
• Therapy mats
• Specialist seating
• Communication boards and other communication devices
• Specialist beds and sleep systems

The aim is not to turn the family home into a clinical environment. Instead, it should provide practical space for the right tools, equipment and activities to support the child’s comfort, physical development and independence.

The best adaptive equipment will depend on the child’s individual strengths, challenges and goals. Occupational therapists and physiotherapists will recommend adaptive tools that are appropriate for their current stage of development and assist children with cerebral palsy improve their ability to take part in everyday activities.

When Is Moving Home Necessary?

Many properties simply cannot be adapted to meet a child’s needs. A family may need to consider moving where:

• The home is too small for essential equipment
• Doorways and hallways cannot be widened
• Single storey accommodation is required
• There is no space for an accessible bathroom
• The child cannot safely access the garden
• Carers need additional space
• The location does not provide suitable parking or transport access
• The structure cannot meet the child’s long-term needs

A property assessment should consider the child’s life as they grow into adulthood. A housing plan that only addresses immediate difficulties is likely to not be suitable as equipment, mobility and care requirements change with age.

Who Assesses a Child’s Accommodation Needs?

Medical negligence solicitors work with independent experts on clinical negligence claims to understand what the child needs now and is likely to need in the future.

This team of experts often include (alongside other medical specialists):

• Occupational therapists
• Care experts
• Accommodation experts/architects
• Physiotherapists
• Assistive technology specialists

An occupational therapist will assess how the child moves around the home, carries out everyday tasks and uses adaptive equipment.

A care expert can consider the support the child requires now and for the rest of their life, including whether there is a need for more than one carer and whether there is a need for night care. They will also comment on the full costs of a care package and consider how this will change at different stages of someone’s life. 

An accommodation expert or architect will consider whether the current property can be adapted to meet the child’s needs now and into the future. They will comment on the type of alternative accommodation the child will need, as well as the costs of adapting this, moving and increased running costs.

This evidence helps build a clear and practical housing plan based on the child’s individual circumstances.

Can Medical Negligence Compensation Fund Suitable Accommodation?

Cerebral palsy is not always caused by medical negligence. A claim may be possible where failures during pregnancy, labour, delivery or the neonatal period caused or materially contributed to the child’s brain injury.

Where a claim succeeds, compensation aims to meet needs arising from the injury. This may include the cost of the following in the context of someone’s property needs:

• Adapting the existing family home
• Moving to suitable accommodation
• Maintaining and repairing adaptations
• Installing ramps, lifts and widened doorways
• Providing an accessible bathroom
• Creating space for equipment and carers
• Purchasing specialist mobility equipment
• Replacing adaptive equipment as the child grows

The assessment will also consider any additional cost of buying and maintaining a suitable property compared with the accommodation the family would otherwise have required.