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Waters Green Dental and Implant Clinic

Inspection Summary


Overall summary & rating

Updated 29 November 2017

We carried out a follow up inspection on 9 November 2017 at Waters Green Dental and Implant Clinic.

On 4 January 2017 we undertook an announced comprehensive inspection of this service as part of our regulatory functions. During this inspection we found breaches of the legal requirements. We carried out a follow-up inspection on 8 August 2017 to check whether the practice met the legal requirements in the Health and Social Care Act 2008 and associated regulations. During the inspection we found two of the breaches of the legal requirements had not been fully addressed.

A copy of the report from both these inspections can be found by selecting the 'all reports' link for Waters Green Dental and Implant Clinic on our website at www.cqc.org.uk.

After the comprehensive inspection, the practice sent us an action plan outlining what they would do to meet the legal requirements in relation to the breaches. This report covers our findings in relation to those requirements only.

We revisited the practice on 9 November 2017 to confirm whether they had followed their action plan, and to confirm that they now met the legal requirements in the Health and Social Care Act 2008 and associated regulations. We carried out this unannounced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

We reviewed the practice against oneof the five questions we ask about services: is the service well-led?

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

Our findings were:

Are services

well-led

?

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

Background

Waters Green Dental and Implant Clinic is a general dental practice located near the centre of Macclesfield. There is level access to facilitate entrance to the practice for people who use wheelchairs and for pushchairs. Car parking is available near the practice.

The practice provides private dental services for adults and children.

The practice is open:

Monday 9:00am - 5:00pm

Tuesday 11:00am - 8:00pm

Wednesday 9:00am to 5:00pm

Thursday 11:00am to 8:00pm

Friday 9:00am to 5:00pm.

The practice team includes a principal dentist, an associate dentist, a hygiene therapist and three dental nurses. One of the dental nurses is currently training to be the practice manager.

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.

Our key findings were:

  • The practice had improved their systems to help them monitor and improve the service, for example, they now had robust processes in place in relation to significant events.
  • The practice had a leadership and management structure. Staff felt involved and supported and worked well as a team.
  • The practice had systems in place to help them assess risk. Measures to reduce risk had been improved.
  • The practice had improved their staff recruitment procedures.
Inspection areas

Safe

No action required

Updated 22 March 2017

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

The premises was spacious, secure and properly maintained. The practice was cleaned regularly and there was a cleaning schedule in place identifying tasks to be completed.

The practice had emergency medicines and equipment available, including an automated external defibrillator. Staff were trained in responding to medical emergencies.

We saw that staff were registered with their professional body, the General Dental Council, and had indemnity insurance in place. Disclosure and Barring checks had been carried out for all staff.

Staff told us they were aware of the need to be open, honest and apologetic to patients if anything was to go wrong; this is in accordance with the Duty of Candour principle.

The provider did not have procedures in place to report and learn from significant events, incidents and accidents.

Staff were aware of how to identify and follow up on abuse but they had not received formal training in relation to safeguarding.

Staff were largely following current guidance for the decontamination and sterilisation of instruments but there were no documented procedures for staff to follow to assist them in the performance of these tasks. No method was in place to ensure the sterilising equipment was continuously functioning correctly.

Most equipment used in the practice, including medical emergency equipment had been appropriately tested and maintained but the X ray machine had not been tested within the recommended period.

Effective

No action required

Updated 22 March 2017

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

The practice followed current guidelines when delivering dental care and treatment to patients.

Patients’ medical history was recorded at their initial visit and updated at subsequent visits. The dentist carried out an assessment of the patient’s dental health. Patients were given a written treatment plan which detailed the treatments considered and agreed, together with the fees involved. Patients’ consent was obtained before treatment was provided; and treatment focused on the patients’ individual needs.

Staff provided oral health advice to patients and monitored changes in their oral health. Patients were referred to other services, where necessary, in a timely manner.

Qualified staff were registered with their professional body, the General Dental Council. Staff received some training to assist them in carrying out their roles but no monitoring was in place to ensure staff were meeting the requirements of their professional regulator.

Caring

No action required

Updated 22 March 2017

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

Patients commented that staff were caring and friendly. They told us they were treated with respect, and that they were happy with the care and treatment given.

Staff understood the importance of emotional support when delivering care to patients who were nervous of dental treatment. Patient feedback on CQC comment cards confirmed that staff were understanding and made them feel at ease.

The practice had separate rooms available if patients wished to speak in private.

We found that treatment was clearly explained, and patients were given time to decide before treatment was commenced. Patients commented that information given to them about options for treatment was helpful.

Responsive

No action required

Updated 22 March 2017

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

Patients had access to appointments to suit their preferences, and emergency appointments were available on the same day. The practice opening hours and the ‘out of hours’ appointment information was provided at the entrance to the practice, in the practice leaflet, and on the practice website.

The practice captured social and lifestyle information on the medical history forms completed by patients which helped the dentists to identify patients’ specific needs and direct treatment to ensure the best outcome was achieved for the patient.

The provider had designed and furnished the premises to take into account the needs of different groups of people, for example, people with disabilities and people whose first language was not English. Staff were prompted to be aware of patients’ specific needs or medical conditions via the use of a flagging system on the dental care records.

The practice had a complaints policy in place however it was not made readily available to patients. Complaints were investigated and responded to in line with the policy.

Well-led

No action required

Updated 29 November 2017

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

After the follow-up inspection on 8 August 2017 the practice provided an action plan explaining the arrangements the practice was putting in place to comply with the regulations.

We reviewed the provider’s systems for monitoring and improving the quality and safety of the service. We found that most policies and procedures were now customised to the practice’s circumstances and scheduled for review. The practice had introduced robust procedures for reporting and learning from significant events and accidents. We saw that these were working well.

We found that the practice had assessed most risks associated with dental practices and had improved the measures they had in place to reduce these risks.

We found that improvements had been made to the staff recruitment processes.

There was a management structure in place and staff felt supported. We saw evidence of regular communication between the principal dentist and trainee practice manager to ensure good governance and leadership were sustained in the long term.