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We are carrying out checks at Duffield Road Dental Care using our new way of inspecting services. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Updated 21 March 2017

We carried out an announced comprehensive inspection on 2 February 2017 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Duffield Road Dental Care is located in premises situated in the northern outskirts of the city of Derby. there are two treatment rooms one of which is situated on the ground floor. The practice provides mostly private dental treatments (60%) There is a small car park for dental patients outside the practice and there is a dedicated disabled parking spot.

The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours were – Monday: 9 am to 8 pm; Tuesday: 9 am to 5:30pm; Wednesday: 9 am to 2:30 pm; Thursday: 9 am to 5:30 pm and Friday: 9 am to 1 pm. The practice was also open alternate Saturdays: 9 am to 1 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients can telephone the NHS 111 telephone number. An NHS out-of-hours dentistry service also operates in Derby.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run

The practice has three dentists; four qualified dental nurses including the practice manager; and one receptionist.

Before the inspection we sent CQC comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received responses from 43 patients through both comment cards and by speaking with them during the inspection. Those patients provided positive feedback about the services the practice provides. Among the themes we identified from patient feedback were that the reception staff were friendly, confidentiality was respected, appointments were convenient, dentists were caring and explained what was happening and the options for treatment and that the premises were clean and well equipped. Several patients said they had been coming to the practice for many years and were very satisfied.

Our key findings were:

  • The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
  • The systems to record accidents, significant events and complaints, learning points from these were recorded and used to make improvements.
  • Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • There were effective systems at the practice related to the Control of Substances Hazardous to Health (COSHH) Regulations 2002.
  • The practice had a consent policy including reference to the Mental Capacity Act 2005.
  • Patients were able to access emergency treatment when they were in pain.
  • Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect and were able to get an appointment that suited their needs.
  • Dental care records demonstrated that the dentists involved patients in discussions about treatment options.
  • The practice offered a sedation service for patients. Sedation at the service carried out safely and was in line with the national guidance.
  • Patients’ confidentiality was protected within the practice.
  • The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
  • The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
  • There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns about a colleague’s practice.
  • The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, medical oxygen and emergency medicines.

There were areas where the provider could make improvements and should:

  • Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and consider installing a hearing induction loop to assist patients and visitors who used a hearing aid.

  • Review staff training to ensure that dental nursing staff who are assisting in conscious sedation have the appropriate training and skills to carry out the role giving due regard to guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015
Inspection areas

Safe

No action required

Updated 21 March 2017

We found that this practice was providing safe care in accordance with the relevant regulations.

There were systems for recording accidents, incidents and complaints.

All staff had received up-to-date training in safeguarding vulnerable adults and children. There were clear guidelines for reporting concerns and the practice had a lead member of staff to offer support and guidance over safeguarding matters. Staff knew how to recognise the signs of abuse, and how to raise concerns when necessary.

There were effective systems at the practice related to the Control of Substances Hazardous to Health (COSHH) Regulations 2002.

The practice had emergency medicines and medical oxygen available, and an automated external defibrillator (AED). Regular checks were being completed to ensure the emergency equipment was in good working order.

When patients received sedation this was done safely with a consultant anaesthetist overseeing the procedure. Sedation was carried out in line with national guidance.

Recruitment checks were completed on all new members of staff. This was to ensure staff were suitable and appropriately qualified and experienced to carry out their role.

The practice was visibly clean and had infection control procedures to ensure that patients were protected from potential risks. Regular audits of the decontamination process were as recommended by the current guidance.

X-ray equipment was regularly serviced to make sure it was safe for use.

Effective

No action required

Updated 21 March 2017

We found that this practice was providing effective care in accordance with the relevant regulations.

All patients were clinically assessed by a dentist before any treatment began. The practice used a recognised assessment process to identify any potential areas of concern in a patient’s mouth including their soft tissues (gums, cheeks and tongue).

Discussions about treatment options were recorded in dental care records.

All staff were supported to meet the requirements of the General Dental Council (GDC) in relation to their continuing professional development (CPD).

The practice was following National Institute for Health and Care Excellence (NICE) guidelines for the care and treatment of dental patients. Particularly in respect of patient recalls, lower wisdom tooth removal and the prescribing of antibiotics for patients at risk of infective endocarditis (a condition that affects the heart).

There was a consent policy which made reference to the Mental Capacity Act 2005.

Caring

No action required

Updated 21 March 2017

We found that this practice was providing caring services in accordance with

the relevant regulations.

Patient confidentiality was maintained and electronic dental care records were password protected.

Feedback from patients identified staff were friendly, and treated patients with care and concern. Patients also said they were treated with dignity and respect and had no concerns with regard to confidentiality at the practice.

There were systems for patients to be able to express their views and opinions and the practice encouraged patients to do so.

Responsive

No action required

Updated 21 March 2017

We found that this practice was providing responsive care in accordance with the relevant regulations.

Patients who were in pain or in need of urgent treatment could usually get an appointment the same day. There were arrangements for emergency dental treatment outside of normal working hours, including weekends and public holidays

The practice had a ground floor treatment room which allowed easy access for patients with restricted mobility. The practice did not have an induction hearing loop to assist patients who used a hearing aid.

Interpreters were readily available for patients whose first language was not English.

There were systems and processes to support patients to make formal complaints. Where complaints had been made these were acted upon, and apologies given when necessary.

Well-led

No action required

Updated 21 March 2017

We found that this practice was providing well-led care in accordance with the relevant regulations.

There was a clear management structure at the practice. Staff were aware of their roles and responsibilities within the dental team, and knew who to speak with if they had any concerns. Staff said they felt well supported and there were systems for peer review and clinical discussion.

The practice had a system for carrying out regular audits of both clinical and non-clinical areas to assess the safety and effectiveness of the services provided. The practice was able to demonstrate that learning and improvements had resulted from the audit process.

Policies and procedures were reviewed annually.

Patients were able to express their views and comments, and the practice listened to those views and acted upon them.