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Inspection Summary


Overall summary & rating

Updated 21 March 2016

We carried out an announced comprehensive inspection on 8 February 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

Coningsby Dental Practice provides NHS dental treatment with approximately 10% private treatment. The provider also owns a practice in Bourne, Lincolnshire which is a much larger practice. The dentist cover for Coningsby is provided by five dentists that work at Bourne and come to work one day per week at Coningsby. Coningsby is a small RAF town in Lincolnshire. The practice is on the main street that runs through the town and is situated in a small converted house. Access to the practice is at the back and the practice has a ramp to enable access to patients with disabilties. The practice has a small reception and waiting area. The practice consists of two treatment rooms however only the downstairs treatment room is accessible to patients in a wheelchair and those with limited mobility. It is a modern practice which allows access all one level. There is also one decontamination room and a small area at the back of reception which is an office and staff area. There is parking available at a nearby pay and display car park.

The dental staff at Bourne dental practice also provide dental services at Coningsby on set days. There are two dentists on Mondays and Thursdays and one the rest of the week. The dentists work on fixed days so that staff are aware of who to book and on which day to book patients. Staff that work at Coningsby are four part time dental nurses and one receptionist. There is also a practice manager who is mainly based at the Bourne practice but provides support and management for Coningsby by telephone or in person.

The practice provides NHS and private dental treatment to adults and to children. The practice is open Monday to Friday from 9am to 5.30pm; and till 6.30pm on a Wednesday and closes at 4.30pm on Fridays. The practice closes for lunch from 1pm until 2pm each day.

The two partners are the registered managers. 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.

We received feedback from 10 patients about the services provided. The feedback reflected positive comments about the staff and the services provided. Patients commented that the practice was clean and tidy. They said that they found the staff offered a professional and friendly service and were helpful and caring. Patients said that explanations about their treatment were clear and that they were always informed of what was happening which made the dental experience as comfortable as possible. Patients said that they were listened to and that any questions they had were answered.

Our key findings were:

  • There were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Infection control procedures were in place and staff had access to personal protective equipment.
  • Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.
  • Patients received clear explanations about their proposed treatment, and its costs, benefits and risks.
  • Patients were treated with dignity and respect and their confidentiality was maintained.
  • The appointment system met the needs of patients and waiting times were kept to a minimum where possible.
  • The practice opened until 6.30pm one evening per week.
  • The practice was well-led, staff felt involved and worked as a team.
  • Staff had been trained to deal with medical emergencies; appropriate medicines and life-saving equipment were readily available and accessible.
  • Governance systems were effective and policies and procedures were in place and reviewed annually.
  • Staff had received formal safeguarding training and were able to describe examples of safeguarding and the process to raise any concerns.
  • A health and safety risk assessment was in place and had been reviewed each year.
  • Clinical audits had taken place however, infection control audits had taken place annually instead of the recommended six monthly.
  • Accidents and significant events were recorded in practice however, there was no process for recording of incidents and near misses.
  • Staff had not received fire safety training.
  • Disability access audit had not taken place although the practice had considered the needs of patients who might have difficulty accessing services due to limited mobility or other physical issues

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

  • Review frequency of infection control audits to be completed every six months.
  • Refresh staff knowledge of whistleblowing procedures
  • Review the incident reporting process to include incidents and near misses to ensure learning and actions are taken to prevent reoccurrence where necessary.
  • Refresh staff training in relation to fire safety.
  • Complete a disability access audit.
Inspection areas

Safe

No action required

Updated 21 March 2016

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

The practice had effective systems and processes in place to ensure all care and treatment was carried out safely. The practice had procedures in place for reporting and learning from accidents and significant events, however low level incidents including near misses were not part of this process.

Staff had received formal training in safeguarding vulnerable adults and children and were able to describe the signs of abuse, Staff were aware of the external reporting process and who the safeguarding lead for the practice was.

Infection control procedures were in place; followed published national guidance and staff had been trained to use the equipment in the decontamination process. The practice was operating an effective decontamination pathway, with robust checks in place to ensure sterilisation of the instruments.

Infection control audits had taken place annually and not every six months as recommended by national guidance.

Effective

No action required

Updated 21 March 2016

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

Explanations were given to patients in a way they understood and risks, benefits and options available to them. Consultations were carried out in line with guidance from the National Institute for Health and Care Excellence (NICE).

There were clear procedures for referring patients to secondary care (hospital or other dental professionals). Referrals were made in a timely way to ensure patients’ oral health did not suffer.

Staff had received training in the Mental Capacity Act (MCA) 2005 as part of the safeguarding training and they were able to explain to us how the MCA principles applied to their roles.

Caring

No action required

Updated 21 March 2016

We found that this practice was providing caring services in accordance with the relevant regulations.

Patients were treated with dignity and respect and their privacy maintained. Patient information and data was handled confidentially. Patients provided positive feedback about the dental care they received, and said that they had confidence in the staff to meet their needs.

Patients said they felt involved in their care. Patients told us that explanations and advice relating to treatments were clearly explained to them and that any questions that they had were answered at a suitable level to be understood.

Responsive

No action required

Updated 21 March 2016

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

The practice was small but well equipped. The waiting room was comfortable and although the reception desk was in the waiting area it was situated to enable confidentiality. The practice had a ramp that they put out for patients that used a wheelchair or had limited mobility. There was a door bell at lower level for patients to use if they needed assistance with the door.

The practice opened later one night to 6.30pm each week.

Well-led

No action required

Updated 21 March 2016

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

Staff were involved in leading the practice to deliver satisfactory care. Care and treatment records had been audited to ensure standards had been maintained.

Staff were supported to maintain their professional development and skills. Staff were receiving annual appraisals and also received six monthly appraisal reviews. The practice was carrying out regular audits of clinical areas to assess the safety and effectiveness of the services provided.

The practice had systems in place to involve, seek and act upon feedback from patients using the service.