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Inspection Summary


Overall summary & rating

Updated 17 January 2019

We carried out this announced inspection on 5 December 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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

Tor Lodge Dental Practice is in Torquay and provides NHS and private treatment to adults and children.

The practice is not accessible for wheelchair users. There are steps to the entrance and treatment rooms are on the first floor, accessible by stairs. Patients are signposted to nearby accessible practices via the practice website or by phoning the practice.

Car parking spaces are available near the practice.

The dental team includes three dentists, one dental nurse, one trainee dental nurse, one dental hygienist, one receptionist and a practice manager/dental nurse. The practice has two treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Tor Lodge Dental Practice was the practice manager.

On the day of inspection we collected 21 CQC comment cards filled in by patients. This gave us a positive view of the practice.

During the inspection we spoke with two dentists, one dental nurse, one receptionist and the practice manager/dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday 1pm – 5pm. Tuesday 9am – 5pm. Wednesday 9am – 2pm. Thursday 9am – 5pm. Friday 9am – 2pm.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The practice staff had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies.
  • The practice had systems to help them manage risk.
  • The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had thorough staff recruitment procedures.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system met patients’ needs.
  • The practice had effective leadership.
  • Staff felt involved and supported and worked well as a team.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice had not received any complaints in the last 12 months.
  • The practice staff had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

  • Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice. In particular evidencing an individual risk based approach to patient recalls, taking into account the National Institute for Health and Care Excellence guidelines.

  • Review the practice’s annual audit cycle, with particular consideration to the inclusion of antibiotic stewardship, to improve the quality of the service.

Inspection areas

Safe

No action required

Updated 17 January 2019

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

The practice had systems and processes to provide safe care and treatment. They used learning from incidents to help them improve.

Staff received training in safeguarding and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed essential recruitment checks.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had suitable arrangements for dealing with medical and other emergencies.

Effective

Updated 17 January 2019

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

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as a relaxing and comfortable experience, professionally delivered. The dentists discussed treatment with patients so they could give informed consent and recorded this in their records.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

The practice supported staff to complete training relevant to their roles and had systems to help them monitor this.

Improvements could be made to the completion of dental care records, to consistently record patient plaque and gum bleeding scores.

Caring

No action required

Updated 17 January 2019

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

We received feedback about the practice from 21 people. Patients were positive about all aspects of the service the practice provided. They told us staff were welcoming and gentle.

They said that they were given helpful, honest explanations about dental treatment, and said their dentist listened to them. Patients commented that they made them feel at ease, especially when they were anxious about visiting the dentist.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 17 January 2019

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

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. The practice had access to telephone and/or face to face interpreter services. The practice wasn’t accessible to wheelchair users but patients using wheelchairs were signposted to accessible nearby practice.

The practice took patients views seriously. They valued compliments from patients and responded to patient feedback about the practice.

Well-led

No action required

Updated 17 January 2019

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

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided. There was a clearly defined management structure and staff felt supported and appreciated.

The practice team kept patient dental care records which were, clearly written or typed and stored securely.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.

Improvements could be made to review the practice’s annual audit cycle, with particular consideration to the inclusion of antibiotic stewardship.