Archived: Appoline Dental Care

Updated 20 August 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 The inspection took place on 7 May 2015 and was conducted by a CQC inspector and a Dentist specialist advisor 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 therefore formed the framework for the areas we looked at during the inspection. Prior to the inspection we asked the practice to send us some information which we reviewed. This included the complaints they had received in the last 12 months, their latest statement of purpose, the details of their staff members, their qualifications and proof of registration with their professional bodies. We also reviewed the information we held about the practice and found there were no areas of concern. During the inspection we spoke with the principal dentist and three associate dentists, the practice manager, three dental nurses and two receptionists. We reviewed policies, procedures and other documents. We reviewed 41 comment cards that we had left prior to the inspection, for patients to complete, about the services provided at the practice. We also spoke with four patients.

Updated 20 August 2015

We carried out an announced comprehensive inspection on 7 May 2015. The practice moved to the present premises in 2013. It is a renovated nursing home converted into a two storey practice with lift, wheelchair access, disabled toilet, own parking, tranquil grounds within close proximity to town centre. It is on a major bus route and a 15 minute walk from train and bus station.

The practice has one principal dentist who is supported by five associate dentists. There is a practice manager, a dental technician, a senior dental nurse, four dental nurses, three trainee dental nurses and two receptionists.

The practice provides primary dental services to both NHS and private patients. The practice is open Monday and Thursday 8.30am – 1pm and 1.45pm – 6pm, Tuesday and Wednesday 8.30am – 1pm and 1.45pm – 7pm and Friday 8.30am – 12.15pm and 1.30pm – 6pm.

The principal dentist is the registered provider for the practice. 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 viewed 41 CQC comment cards that had been left for patients to complete, prior to our visit, about the services provided. All of the comment cards reflected positive comments about the staff and the services provided. Patients commented that the practice was clean and hygienic, they found the staff very friendly and approachable and they found the quality of the dentistry to be excellent. They said explanations were clear and made the dental experience as comfortable as possible. We found the practice was providing safe, effective, caring, responsive and well-led care on accordance with the relevant regulations.

Our key findings were:

• The practice recorded and analysed significant events and complaints and cascaded learning to staff.
• Where mistakes had been made patients were notified about the outcome of any investigation and given a suitable apology.
• Staff had received safeguarding and whistleblowing training and knew the processes to follow to raise any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.
• Infection control procedures were in place and the practice followed published guidance.
• Patient’s care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
• 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 was well-led and staff felt involved and worked as a team.
• Governance systems were effective and there was a range of clinical and non-clinical audits to monitor the quality of services.
• The practice sought feedback from staff and patients about the services they provided.

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

• Deploy universally the practice rubber dam protocol for root canal treatments by all clinicians. (A rubber dam isolates selected teeth and safeguards the rest of the patient’s mouth during treatment). If a rubber dam is not used this must be for a clinical reason only and as such should be documented on the patient record.
• Adopt an individual risk assessment process for oral disease as outlined in National Institute for Health and Care Excellence (NICE) guidance in deciding when to recall patients for review.
• Those staff that have not yet received tuition in the Mental Capacity Act 2005 to complete training in the subject.