Archived: Perfect Profiles - Wolverhampton

Updated 21 June 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 inspected Perfect Profiles - Wolverhampton on 10 May 2016. The inspection was carried out by one CQC inspector and a dentist specialist advisor.

Prior to the inspection we reviewed information we held about the provider from various sources. We also requested details from the provider in advance of the inspection. This included their latest statement of purpose describing their values and objectives and a record of patient complaints received in the last 12 months.

During the inspection we toured the premises, spoke with the area manager, practice manger, general manager, two dentists, and three dental nurses. We also reviewed CQC comment cards which patients had completed and spoke with patients. We reviewed a range of practice policies and practice protocols and other records relating to the management of the service. Unfortunately, two staff members were absent on the day of our visit due to sickness – they were the CQC manager and the clinical director. As a consequence, a substantial amount of information was sent to us via email after our visit. This was because many documents were not available during the inspection.

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 21 June 2016

We carried out an announced comprehensive inspection on 10 May 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

Perfect Profiles - Wolverhampton is a dental practice providing general dental services on a private basis to adults only. The service is provided by four dentists (one of whom is the clinical director). They are supported by seven dental nurses (one of whom is currently on maternity leave). The dental nurses were also trained to carry out reception duties and one of the dental nurses also fulfils the role of the treatment coordinator. The practice’s managerial duties were carried out by a Care Quality Commission(CQC) manager, an area manager, a practice manager and a general manager. Three of the dentists were involved in the provision of dental implants and complex oral surgery to patients.

The whole practice is situated on the ground floor so can accommodate patients with restricted mobility. The premises consist of a reception area, waiting room, two treatment rooms, a decontamination room, an X-ray room, a staff room and an office. In addition, there are toilet facilities for patients with disabilities and a room for patients to have consultations with the treatment coordinator. There is free parking outside the practice. Opening hours are from 9am to 5:30pm on Monday to Friday.

The CQC practice manager 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.

Six patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with patients on the day of our visit. Patients were positive about their experience and they commented that staff were friendly and professional.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The practice appeared visually clean on the day of our visit.
• The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding and the management of medical emergencies. We identified some areas for improvement and we were told these would be actioned promptly.
• Patients’ care and treatment was not always planned and delivered in line with evidence based guidelines, best practice and current legislation. Some of the dental care records were not sufficiently detailed.
• Staff received training appropriate to their roles.
• Patients told us they found the staff friendly and professional. Patients commented they felt involved in their treatment and that it was fully explained to them.
• Patients were able to make routine and emergency appointments when needed. Some patients commented they had to wait beyond their scheduled appointment time.
• The practice had an effective complaints process in place and the practice was able to demonstrate they made improvements as a direct result of patient feedback.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• The practice demonstrated that they regularly undertook audits in infection control, radiography and dental care record keeping. However, learning points and action plans were not always documented.

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

• Review monitoring arrangements for the availability of equipment and safe storage of medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK) and the General Dental Council (GDC) standards for the dental team. Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
• Review the arrangements for identifying staff training, learning and development needs and have an effective process established for the on-going assessment and supervision of all staff.
• 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.