The Cannon Hill Clinic

We carried out an announced comprehensive inspection on 21 December 2015 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.

The practice provided private dental treatment to patients of all ages in Southgate and surrounding areas. The premises are situated on the ground floor of a residential style building. The services provided include preventative advice and treatment and routine restorative dental care.

Practice staffing consisted of the principal dentist, who is also the owner/provider, one dental nurse and three receptionists.

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.

The practice consists of one treatment room, reception a large waiting area for patients, a separate decontamination room, office and a staff room.

We received feedback from 11 patients.

All patients commented positively about the care and treatment they had received and the friendly, efficient and professional staff. A number of patients commented on the sympathetic, understanding dentists who had helped them overcome their fears and friendly reception staff.

The practice is open on Tuesday, Thursday and Fridays from 9am-6pm.

Our key findings were:

• The practice investigated significant and safety events and cascaded learning to staff. These events were analysed and monitored to help improve patient safety.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• There were systems in place to ensure that all equipment, including the suction, compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment, were maintained in line with manufacturer’s guidelines.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• Patients’ care and treatment was planned and delivered in line with current legislation and evidence based guidelines such as that from the National Institute for Health and Care Excellence (NICE).
• The practice ensured staff were trained and that they maintained the necessary skills and competence to support the needs of patients.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available. However, staff did not have access to an automated external defibrillator (AED), in line with Resuscitation Council UK guidance.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients. The principal dentist told us that no complaints had been received about the service.
• The practice was well-led and staff felt valued, involved and worked as a team. Staff meetings were routinely held to help share information and learning.
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice.
• Clinical and non-clinical audits were carried out to monitor the quality of services.
• The practice had not undertaken a Legionella risk assessment in line with current national guidance.
• The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.

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

• Review the availability of equipment to manage medical emergencies giving due regard to guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the current infection control protocols and undertake a Legionella risk assessment and implement the required actions giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.