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Inspection summaries and ratings from previous provider


Overall summary & rating

Updated 21 March 2017

We carried out an announced comprehensive inspection on 1 March 2017 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

Hob Hey Dental Centre is located in a residential suburb close to the centre of Culcheth. It comprises a reception and waiting room, a treatment room and patient toilet facilities on the ground floor, and two treatment rooms and a decontamination room on the first floor. Parking is available outside the practice in the practice’s car park. The practice is accessible to patients with disabilities, limited mobility, and to wheelchair users.

Much of the practice has been re-furbished and re-decorated and the provider has plans for completion of the remainder.

The practice provides general dental treatment to children and students on an NHS basis and to patients of all ages on a privately funded basis. The practice also provides a limited range of general dental treatment to patients in nursing and residential homes. The opening times are Monday, Wednesday, Thursday and Friday 8.15am to 7.30pm and Tuesday 8.15am to 5.00pm. The practice is staffed by a principal dentist, two practice managers, two associate dentists, a dental therapist, two dental hygienists and five dental nurses.

The principal dentist 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.

We received feedback from 48 people during the inspection about the services provided. We also received feedback from 17 people via the CQC Share your Experience facility on the website. Patients were extremely positive about all aspects of care. Patients commented that they found the practice excellent and well organised, and that staff were not only professional, friendly, and caring but they went beyond their call of duty. They said the dentists listened carefully to them, put them at ease and always gave them good and helpful explanations about dental treatment. Patients commented that the practice was clean, comfortable and provided a relaxing environment.

Our key findings were:

  • The practice had procedures in place to record, analyse and learn from significant events and incidents.
  • Staff had received safeguarding training, and knew the processes to follow to raise concerns.
  • There were sufficient numbers of suitably qualified and 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 instruments.
  • Patients’ needs were assessed, and care and treatment were delivered, in accordance with current 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.
  • The practice gathered and took account of the views of patients.
  • Staff were supervised, felt involved, and worked together as a team.
  • Robust governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.

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

  • Review the practice’s procedures for undertaking domiciliary visits in accordance with The British Society for Disability and Oral Health 2009 Guidelines for the delivery of a domiciliary oral healthcare service, specifically in relation to the availability of medicines and equipment to manage medical emergencies.
Inspection areas

Safe

No action required

Updated 21 March 2017

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. Staff were trained in responding to medical emergencies.

We found the equipment used in the practice was well maintained and tested at regular intervals.

The premises were secure and maintained to a high standard. The practice was cleaned regularly.

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

The principal dentist provided treatment for patients of local care homes where the patients were unable to attend the practice in person. Not all recommended emergency medicines and equipment were taken on these visits. The provider assured us this would be rectified.

Effective

No action required

Updated 21 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 reviewed at every appointment. Dentists carried out an assessment of the patient’s dental health and monitored changes in it.

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.

Patients were referred to other services, where necessary, in a timely manner.

Staff were registered with their professional regulator, the General Dental Council, where relevant, and were supported in meeting the requirements of their registration. Staff received on-going training to assist them in carrying out their roles.

Caring

No action required

Updated 21 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 21 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 readily available.

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 for the patient.

The provider had taken into account the needs of different groups of people and put adjustments in place. Staff were prompted to be aware of patients’ specific needs or medical conditions.

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 21 March 2017

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 and manager were approachable and helpful, and took account of their views.

The practice was a member of a practice accreditation scheme at the highest level. Accreditation schemes require a commitment by a practice to provide dental care to nationally recognised standards.

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, audits, 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. The practice welcomed feedback from patients on all aspects of the service and acted on the feedback. 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.