Updated 17 November 2017
We carried out this announced inspection on 19 October 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?
These questions form the framework for the areas we look at during the inspection.
Our findings were:
Are services safe?
We found that this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found that this practice was providing effective care in accordance with the relevant regulations.
Are services caring?
We found that this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found that this practice was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found that this practice was providing well-led care in accordance with the relevant regulations.
Background
St Peters Avenue Dental Practice is in Cleethorpes and provides private dental treatment to adults and children. Services include conscious sedation and dental implants.
There are steps at the front entrance to the practice with handrails positioned alongside to assist patients with limited mobility. The provider has a portable ramp to facilitate access to the practice for wheelchair users. Car parking spaces are available near the practice.
The dental team includes two dentists, four dental nurses, one receptionist and a practice manager. The practice has two treatment rooms.
The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
On the day of inspection we collected 43 CQC comment cards filled in by patients. This information gave us a positive view of the practice.
During the inspection we spoke with two dentists, three dental nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday to Thursday from 9:00am to 6:00pm
Friday from 8:30am to 1:30pm
Our key findings were:
- The practice was clean and well maintained.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Adjustments could be made to bring the medical emergency kit in line with current guidance.
- The practice had systems to help them manage risk.
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
- Improvements could be made to the recruitment process.
- Improvements could be made to the process for ensuring equipment is maintained appropriately.
- The clinical staff were not fully aware of current guidelines for providing clinical care.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- The appointment system met patients’ needs.
- The practice had a leadership structure in place. Staff felt involved and supported and worked well as a team.
- The practice asked staff and patients for feedback about the services they provided.
- The practice dealt with complaints positively and efficiently.
There were areas where the provider could make improvements and should:
- Review the practice’s system for the recording and following up sharps injuries.
- Review staff awareness of Gillick competency, the Mental Capacity Act (MCA) 2005 and current guidance from the National Institute for Health and Care Excellence (NICE).
- Review the practice’s process for ensuring X-ray equipment is maintained in line with manufacturer’s guidance.
- Review the practice's recruitment policy and procedures to ensure Disclosure and Barring Service (DBS) checks for new staff as well as proof of identification are requested and recorded suitably.