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Inspection Summary


Overall summary & rating

Updated 1 December 2016

We carried out an announced comprehensive inspection on 25 October 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

Roe Street Dental Practice is located in the centre of Macclesfield and comprises a reception and waiting room on the ground floor, and three treatment rooms on the first floor. Parking is available in nearby car parks. The practice is accessible to patients with disabilities and impaired mobility, but not to wheelchair users.

The practice provides general dental treatment to patients on an NHS or privately funded basis. The opening times are Monday to Thursday 9.00am to 5.00pm and Friday 9.00am to 4.45pm. The practice is staffed by a principal dentist, three associate dentists, a dental therapist/hygienist, six dental nurses, and one receptionist.

The principal dentist is registered with the Care Quality Commission as an individual. 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 ten people during the inspection about the services provided. Patients commented that they found the staff friendly, and caring, and that all the staff listened to them and took appropriate action. They commented that the dentists were knowledgeable and that they were always given good and helpful explanations about dental treatment. Patients commented that the practice was clean and comfortable.

Our key findings were:

  • The practice had procedures in place to record and analyse significant events and incidents.
  • Staff had received safeguarding training, and knew the process to follow to raise concerns.
  • There were sufficient numbers of suitably qualified, skilled staff to meet the needs of patients.
  • Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
  • The premises and equipment were clean, secure and well maintained.
  • Staff followed current infection control guidelines for decontaminating and sterilising equipment.
  • Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
  • Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
  • Staff were supported to deliver effective care, and opportunities for training and learning were available.
  • Patients were treated with kindness, dignity, and respect, and their confidentiality was maintained.
  • The appointment system met the needs of patients, and emergency appointments were available.
  • Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
  • The practice gathered the views of patients and took their views into account.
  • Staff were supervised, felt involved, and worked as a team.
  • Governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.

We identified the practice did the following which had a positive impact on patient experience and health outcomes.

The provider demonstrated a commitment to promoting a good quality of life to patients and supporting patients to achieve positive outcomes, in respect of their general health and well-being, in addition to their oral health.

  • The provider was aware that people often experienced a range of issues in their lives in relation to, for example, health or social problems, and did not always feel comfortable in addressing those directly with a health care professional. We observed that the provider had produced a range of information cards for patients to take away providing brief information on sources of specialised help and advice, for example, Childline, NSPCC, Mind and other organisations providing help with health issues, abuse or domestic violence. The cards were made available to patients in a discreet location in the patient toilet facilities.

We believe this to be notable practice worth sharing as it demonstrates involvement with the local community and other organisations to make sure people’s needs are met. 

Inspection areas

Safe

No action required

Updated 1 December 2016

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

The provider had systems and processes in place to ensure care and treatment were carried out safely, for example, there were systems in place for infection prevention and control, dental radiography, and for investigating and learning from incidents and complaints.

Staff were appropriately recruited, suitably trained and skilled.

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

We found the equipment used in the practice, including medical emergency and radiography equipment, was well maintained and tested at regular intervals.

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

There was guidance for staff on the decontamination of dental instruments which they were following.

The practice was following current legislation and guidance in relation to X-rays, to protect patients and staff from unnecessary exposure to radiation.

Effective

No action required

Updated 1 December 2016

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.  Clinicians obtained consent from patients before treatment was provided; and treatment focused on the patients’ individual needs. Patients were given a written treatment plan which detailed the treatments considered and agreed, together with the fees involved.

Patients received an assessment of their dental health. 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.

The provider had produced a range of information cards for patients to take away with details of sources of advice and help on a range of health and social issues.

Qualified staff were registered with their professional body, the General Dental Council, and were supported in meeting the requirements of their professional regulator. Staff received on-going training in a variety of subjects to assist them in carrying out their roles.

Caring

No action required

Updated 1 December 2016

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 1 December 2016

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. Patients could request appointments by telephone or in person. 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. Dentists were familiar with the specific issues of their patient population and regularly updated their knowledge of these issues.

The provider had taken into account the needs of different groups of people and put adjustments in place, for example, for people with disabilities and patients 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 which was displayed in the waiting room and outlined in the practice leaflet, and on the practice website. Complaints were thoroughly investigated and responded to appropriately.

Well-led

No action required

Updated 1 December 2016

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

The provider had effective systems and processes in place for monitoring and improving services.

The practice had a management structure in place, and some of the staff had lead roles. Staff reported that the provider was approachable and helpful, and took account of their views.

The provider had put in place a range of policies, procedures and protocols to guide staff in undertaking tasks and to ensure that the service was delivered safely. We saw that these were regularly reviewed.

The provider used a variety of means to monitor quality and safety at the practice and to ensure continuous improvement in the practice, for example, learning from complaints and patient feedback.

Staff were aware of the importance of confidentiality and understood their roles in this. Dental care records were complete, accurate, and securely stored. Patient information was handled confidentially.

The culture of the practice encouraged openness and honesty. Staff told us they were encouraged to raise any issues or concerns.

The practice held regular staff meetings, and these gave everybody an opportunity to openly share information and discuss any concerns or issues.