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Inspection carried out on 26 June 2019

During a routine inspection

We carried out this announced inspection on 26 June 2019 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

Cowplain Dental Practice is in Waterlooville and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes four dentists, seven dental nurses, two trainee dental nurses, four dental hygienists, three dental hygiene therapists, one dental technician, one practice manager, one cleaner and one receptionist. The practice has six treatment rooms.

The practice is owned by a partnership 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 Cowplain Dental Practice is the principal dentist. A registered manager is legally responsible for the delivery of services for which the practice is registered

On the day of inspection, we collected 71 CQC comment cards filled in by patients and spoke with three other patients.

During the inspection we spoke with four dentists, six dental nurses, one trainee dental nurse, one dental hygienist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Tuesday and Thursday 8am to 6pm

Wednesday and Friday 8am to 5.30pm

Our key findings were:

  • The practice appeared clean and well maintained.
  • The provider had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The practice had systems to help them manage risk to patients and staff.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider 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.
  • Improvements could be made to Control of Substances Hazardous to Health (COSHH) Regulations 2002 file to ensure the safe storage and use of materials used.
  • Improvements could be made by having in place a risk assessment for when the dental hygienist/hygiene therapist worked without chairside support.
  • Improvements could be made to the fire risk assessment by ensuring that it is carried out by a qualified or competent person.
  • The practice offered direct access to a dental technician in a regular dental clinic. This service served patient needs and is to be commended.
  • Improvements could be made to the auditing process, and ensure that patient care notes are in line with FGDP guidelines.
  • Staff were providing preventive care and supporting patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • The provider had effective leadership and culture of continuous improvement.
  • Staff felt involved and supported and worked well as a team.
  • The provider asked staff and patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • The provider had suitable information governance arrangements.

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

  • Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.

  • Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.

  • Review the practice’s protocols to ensure audits of radiography, dental care records, antimicrobial prescribing and infection prevention and control are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.