Steps are the biggest barrier to independent access

The following simple, practical measures can help disabled users to access dental services. The steps follow a patient's pathway to and through your practice.

Are patients able to find the entrance easily?

The entrance should be easy to find from the street, car park or other routes to the building. Possible adjustments include:

  • Adding clear directional signs with the street name, number and telephone number.

  • A hanging sign above the entrance, if planning permission allows

  • Painting the door frame a contrasting colour helps

  • Relocate the main entrance where it is easily identifiable

  • A rear or side entrance nearby might be an accessible entrance for wheelchair users.

  • Improved external lighting

  • Extra-wide parking bays for the disabled,

  • Surfaces should be free of trip hazards, firm and not slippery.

External steps

Steps are the biggest barrier to independent access. Try:

  • Raising a section of the pavement to the level of the door; this may be difficult, so negotiate with the local authority

  • An external ramp, preferably permanent, if there is sufficient space

  • An internal ramp if there is sufficient space

  • Temporary ramps, available from commercial suppliers, need to be firm and secure and stored somewhere when not in use

  • Handrails should be fitted for disabled persons who do not use wheelchairs and steps clearly marked

  • Paint a strip of colour on the edge of steps, which contrasts with the main part of the step, and

  • Improve the lighting.

Call bells

A call bell or entry phone system, at a suitable height for wheelchair users, could be installed to alert staff. For those with visual impairment, there should be a visible indication, eg a flashing light, to show that the call has been answered or the door catch released.

Doors

  • Door thresholds should be flush. The recommended maximum is for a 13mm lip

  • Doors should be wide enough to clear double buggies and wheelchairs

  • Door handles should be at a convenient height

  • Entrance mats should be flush

  • Glazed doors should have clear safety markings

  • Door closers should be regularly maintained.

Emergency exits

Practices should have a strategy to enable disabled patients to escape from the building eg flashing light alarms and special aids such as evacuation chairs to carry people downstairs:

  • Keep exits free of obstruction

  • Ensure all alarm systems are in working order and procedures are in place and tested regularly

  • Ensure that new staff are trained with attention to assisting patients with visual or mobility impairments.

Layout of the practice

The internal structure design, the location of shelves, display cabinets and reception desks should meet the requirements of patients with disabilities.

For example:

  • Floors, walls, ceilings and door frames can be distinguished by using contrasting colours

  • Signs should be easily located, simple, short and easy to read

  • Reception desks should be positioned away from windows and part of the desk should be at a level where a patient sitting in a wheelchair can enjoy face-to-face communication with the receptionist and lean on to sign cheques etc. To help those who lipread, the desk should be where staff members will not be put in shadow by bright sunshine

  • In cases where it is not possible to create the physical conditions in which customers with different disabilities can move around easily and safely, it would be reasonable to provide staff assistance.

If it is not possible to make reception desks or display cabinets fully accessible, it may be possible to alter working practices. Staff could come out from behind the desk to meet a wheelchair-using patient and carry out transactions in this way. They could get items down from inaccessible cabinets or shelving for patients to look at.

It is important that there is adequate space for wheelchair users to manoeuvre through aisles and corridors. The recommended width is 1200mm.

  • Keep aisles, corridors, areas near doors and other circulation space as uncluttered as possible.

  • Fit handrails where there is one or more internal step or internal ramp.

  • The edges of internal steps could be clearly marked with a contrasting colour

  • Poorly fitted mats should be relayed and uneven junctions of floor surfaces should be repaired

  • Surfaces should retain their slip resistance.

Waiting areas and seating

Provide a mixture of seating with and without armrests and at a range of heights. Consider the positioning of furniture in the waiting areas so that there is space for a wheelchair user to pull up alongside a seated companion. Announcement systems should be both visible and audible so that they can be understood by customers with hearing and visual impairments.

Lighting

  • Highlight hazardous areas with additional lighting in places like stairwells or changes in floor level

  • Maximise light by ensuring windows, lamps and blinds are kept clean and used light bulbs are promptly replaced

  • Where there are large surfaces of white or highly reflective finish, glare and reflection could be a problem for patients with partial sight. It is advisable to adjust or relocate the lighting to reduce those effects, and

  • Lights should not cause undue glare or reflections, so avoid glass where possible.

Communicating with staff

Improvements to enhance communication for people with hearing impairments can be undertaken. Some are simple, such as induction loops, whilst others are more complicated, such as infrared systems. Keeping background noise to a minimum helps. You might consider putting in sound insulation and avoiding too many hard surfaces. A member of staff may learn sign language.

  • Improve lighting conditions to allow patients to lip read easier

  • Use alternative means of communication where induction loops are not possible eg a voice enhancement system or exchange of written notes. Sometimes it may be necessary to provide a British Sign Language interpreter for the patient

  • Look straight at patients and be careful not to cover your mouth when speaking. Allow extra time and repeat back to the patient to check accuracy and understanding

  • It may be possible to separate quiet and noisy areas by planning the use of practice space to benefit all patients, particularly those with hearing impairments.

Publications

The Disability Rights Commission provides the following publications free of charge:

Making Access to Goods and Services Easier for Disabled Customers: A Practical Guide for Small Businesses and Other Service Providers

Good Signs - Improving Signs for People with a Learning Disability

Improving the services dentists provide to disabled people

Contact the Disability Rights Commission, www.drc-gb.org or phone 08457 622 633.

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