Updated 7 February 2020
We carried out this announced inspection on 17 December 2019 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 Care Quality Commission, (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 this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found this practice was providing effective care in accordance with the relevant regulations.
Are services caring?
We found this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found this practice was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
Background
Kirkpatrick Dental Practice is in Mansfield Woodhouse in north Nottinghamshire and provides NHS and private dental care and treatment for adults and children.
All patient areas apart from reception are located on the first floor. Should a patient with mobility difficulties require treatment, they would be referred to another local buddy practice where they could access treatment. There is car parking available in the supermarket near the practice.
The dental team includes one dentist, one dental hygiene therapist, six dental nurses including two apprentices and the practice manager. The practice has two treatment rooms, both of which are located on the first floor. The practice has centralised decontamination facilities.
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 36 CQC comment cards filled in by patients and spoke with two other patients. Feedback received about the practice was positive.
During the inspection we spoke with the dentist, the dental hygiene therapist and four dental nurses. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open: Monday: from 9am to 5pm, Tuesday: from 9am to 7pm, Wednesday: from 9am to 5pm, Thursday: from 9am to 7pm and Friday: from 9am to 1pm.
Our key findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider had systems to help them manage risk to patients and staff.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which reflected current legislation.
- The dentist did not always use a dental dam in line with guidance from the British Endodontic Society when providing root canal treatment.
- Dental care records could be improved to include more information about risks and treatment options.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- Improvements were needed when dispensing antibiotic medication, to ensure the labelling of the medicines followed the Human Medicines Regulations 2012.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider had systems in place to deal with complaints positively and efficiently.
- The provider had information governance arrangements.
There were areas where the provider could make improvements. They should:
- Take action to ensure the dentist is aware of the guidelines issued by the British Endodontic Society for the use of dental dam for root canal treatment.
- Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
- Take action to ensure medicines which are dispensed by the practice are labelled in compliance with the Human Medicines Regulations 2012.
- Take action to ensure the clinicians take into account the guidance provided by the Faculty of General Dental Practice when completing dental care records.