Greenleaves Dental Practice

Updated 8 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We carried out an announced, comprehensive inspection on 19 July 2016. The inspection team consisted of a Care Quality Commission (CQC) inspector and a dental specialist advisor.

Before the inspection we asked the practice for information to be sent, this included the complaints the practice had received in the last 12 months; their latest statement of purpose; the details of the staff members, their qualifications and proof of registration with their professional bodies. We spoke with six members of staff during the inspection.

We reviewed the practice’s policies, procedures and other documents. We received feedback from 28 patients about the dental service.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 8 September 2016

We carried out an announced comprehensive inspection on 19 July 2016 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

Greenleaves Dental Practice is a general dental practice situated in the town of Potters Bar, Hertfordshire. It provides general dentistry to adults and children funded by the NHS or privately. They also offer the placement of implants (where a metal post is placed surgically into the jaw bone to support a tooth or teeth) and offer treatment under conscious sedation (these are techniques in which the use of a medicine or medicines produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation).

The practice is situated on the high street in Potters Bar with good public transport links, and free car parking a short walk from the practice.

The practice is open from 8 am to 7 pm on Monday and Tuesday, 8 am to 6 pm on Wednesday and Thursday, 8 am to 5pm on Friday and 8 am to 3 pm on a Saturday.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. 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.

Prior to our visit we left comment cards at the practice which we collected on the day of the inspection. 28 patients provided feedback about the service in this way. Patients reported very positively about the service.

Our key findings were:

• The practice was visibly clean and clutter free.

• Patients reported positive experiences at the practice and commented that they were treated with care and understanding.

• The practice could normally arrange a routine appointment within one to two days and emergency appointments mostly on the same day.

• The practice offered evening and Saturday appointments to allow flexibility for those with commitments during normal working hours.

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

• The practice had all the emergency equipment recommended by the Resuscitation Council UK for use in a medical emergency, and all emergency medicines as recommended in the British National Formulary.

• The clinicians used nationally recognised guidelines in the care and treatment of patients.

• X-ray machines, although serviced, had not been tested for dose within the recommended three years, although this was arranged shortly following the inspection.

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

• Establish whether the practice is in compliance with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.

• Review the practice’s protocols for conscious sedation, giving due regard to 2015 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.

• Review the practice's recruitment policy and procedures to ensure character references for new staff as well as proof of identification are requested and recorded suitably.

• Review the protocols and procedures to ensure staff are up to date with their mandatory training and their Continuing Professional Development.

• Review the practice’s audit protocols for completion of infection control audits at regular intervals to help improve the quality of service. Practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.

• Review the procedures to track referrals made to other services, and ensure that this is used consistently.