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Inspection Summary


Overall summary & rating

Updated 4 November 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Grendon Lodge is part of the Houston Group of Dental Practices. It has recently been fully renovated and offers a modern well equipped practice with disabled facilities and a ground floor surgery. There is free on street parking by the practice.

This modern dental practice uses the latest techniques and state of the art equipment. The services provided are both NHS and private and the fees for all services are displayed on the practice website and in information leaflets available in the practice for patients.

The practice has four treatment rooms, a waiting area and a local decontamination unit. One treatment room and a disabled toilet are available on the ground with level access throughout. The practice has a team of clinicians with a variety of expertise and patients may see different clinicians for different parts of their treatment.

The practice has a principal dentist and a practice manager. The registered manager works across all practices in the Houston group. 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.

The practice is open Monday –Friday 9.00am - 1.00pm and 2.00pm – 5.30pm on Monday, Wednesday, Thursday and Friday; on Tuesday 2.00pm - 7.30pm. The practice is closed at weekends. For emergency and out of hour’s assistance contact information is available from the practice telephone answering service.

We reviewed 49 CQC comment cards that had been left for patients to complete, prior to our visit, about the services provided. In addition we spoke with four patients on the day of our inspection. Feedback from patients was positive about the care they received from the practice. They commented staff put them at ease, listened to their concerns and provided an excellent service in which they had confidence in the dental care provided.

Our key findings were:

  • There were systems in place to help ensure the safety of staff and patients. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control and responding to medical emergencies.

  • The dental practice had effective clinical governance and risk management processes in place; including health and safety and the management of medical emergencies.

  • The practice had a comprehensive system to monitor and continually improve the quality of the service; including through a detailed programme of clinical and non-clinical audits.

  • Use of Loups –These enable the clinician to have a magnified view of the operation site thus enabling extreme accuracy of treatment.

  • The use of digital photography to explain treatments to patients while in the chair and manipulate images to show outcome of proposed treatment.

  • Premises were well maintained and a tour of the building confirmed that good cleaning and infection control systems were in place. The treatment rooms were well organised and equipped, with good light and ventilation.

  • There were systems in place to check all equipment had been serviced regularly, including the air compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.

  • There were sufficient numbers of suitably qualified staff who maintained the necessary skills and competence to support the needs of patients.

  • Staff were up to date with current guidelines and the practice was led by a proactive principal dentist / provider.

  • Staff were kind, caring, competent and put patients at their ease.

  • Patients commented they felt involved in their treatment and that it was fully explained to them.

  • Common themes from the CQC comment cards were patients felt they received excellent care in a clean environment from a helpful practice team who put them at their ease.

  • Information about how to complain was available and easy to understand.
Inspection areas

Safe

No action required

Updated 4 November 2016

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

There were systems in place to help ensure the safety of staff and patients. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control and responding to medical emergencies. The practice carried out and reviewed risk assessments to identify and manage risks.

There were clear procedures regarding the maintenance of equipment and the storage of medicines in order to deliver care safely. In the event of an incident or accident occurring; the practice documented, investigated and learnt from it.

Effective

No action required

Updated 4 November 2016

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

The practice kept detailed electronic records of the care given to patients including comprehensive information about patients’ oral health assessments, treatment and advice given. They monitored any changes in the patient’s oral health and made referrals to either one of the specialists in their other practices in the group or to hospital specialist services for further investigations or treatment if required.

The practice was proactive in providing patients with advice about preventative care and supported patients to ensure better oral health. Comments received via the CQC comment cards reflected patients were very satisfied with the assessments, explanations, the quality of the dentistry and outcomes they experienced.

Staff spoken with told us they had accessed specific training in the last 12 months in line with their professional development plan.

Caring

No action required

Updated 4 November 2016

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

We reviewed 49 completed CQC comments and received feedback from four patients about the care and treatment they received at the practice. The feedback was positive with patients commenting on the excellent service they received, professionalism and caring nature of the staff and ease of accessibility in an emergency. Patients commented they felt involved in their treatment and that it was fully explained to them.

We observed privacy and confidentiality were maintained for patients using the service on the day of the inspection. Policies and procedures in relation to data protection and security and confidentiality were in place and staff were aware of these.

Responsive

No action required

Updated 4 November 2016

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

The practice offered routine and emergency appointments each day. There were clear instructions for patients requiring urgent care when the practice was closed. The practice supported patients to attend their forthcoming appointment by having a reminder system in place. Patients who commented on this service reported this was helpful.

There was level access into the building for patients with limited mobility and prams and pushchairs. Services were provided on the ground floor with level access throughout and the area was spacious enough to manoeuvre a wheelchairs. For patients without mobility difficulties services were provided on the first floor of the building. We observed the reception desk was compliant with the Disability Discrimination Act 1995 and the Equality Act 2010.

There was a procedure in place for acknowledging, recording, investigating and responding to complaints and concerns made by patients or their carers.

Well-led

No action required

Updated 4 November 2016

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

The practice assessed risks to patients and staff and carried out a programme of audits as part of a system of continuous improvement and learning. There were clearly defined leadership roles within the practice and staff told us they felt well supported.

The practice had accessible and visible leadership with structured arrangements for sharing information across the team, including holding regular meetings which were documented for those staff unable to attend. Staff told us that they felt well supported and could raise any concerns with the practice manager who worked closely with the registered manager.

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