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Inspection Summary


Overall summary & rating

Updated 4 July 2016

We carried out an announced comprehensive inspection on 7 June 2016 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

Family Dental Practice is situated in Shipston-on-Stour and mainly provides NHS dental treatment. Private treatment is available if patients request this. The practice has two dentists, two dental nurses and one trainee dental nurse. The clinical team are supported by two reception staff.

The two dentists are in partnership as the owners and registered providers. One of the partners 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 has two dental treatment rooms. The practice is in the process of setting up a separate decontamination room for the cleaning, sterilising and packing of dental instruments. In the meantime staff carry out these processes in the treatment rooms. There is level access from the front entrance into the reception, waiting room and one treatment room. Some patients with disabilities choose to use the rear entrance which has a step down but is closer to the adjacent car park. The patient toilet is has a grab rail for patients with physical disabilities but is not large enough for wheelchairs. There are two steps up to the other treatment room. The office and the staff areas are on the first floor of the building and are reached by an external staircase.

The practice is open from 9am to 5pm Monday to Friday. Reception is staffed during the lunch hour so that patients can speak to someone if they call in or telephone during that time.

Before the inspection we sent Care Quality Commission comment cards to the practice so patients could tell us about their experience of the practice. We collected 27 completed cards and looked at the practice’s own monthly patient survey results and the NHS Friends and Family test results for the last 12 months. These provided a consistently positive view of the practice and the care and treatment patients received. Patients described the whole practice team as caring, friendly, reassuring and efficient. Several patients commented on how well the dentists explained the treatment they needed and the effort they took to make sure they understood. The NHS Friends and Family test results showed that from a total of 408 responses, 316 patients said they were extremely likely to recommend the service and 80 were likely to recommend it.

Our key findings were:

  • The practice was visibly clean and feedback confirmed this was patients’ experience. The practice had systems to assess and manage infection prevention and control and were making improvements to the decontamination arrangements at the practice.

  • The practice had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.

  • The practice had clear processes for dealing with medical emergencies and for ensuring that dental equipment was regularly maintained.

  • Dental care records provided clear and detailed information about patients’ care and treatment.
  • Staff received training appropriate to their roles and were supported in their continued professional development. The practice supported new staff and used a structured induction process.

  • Patients were able to make routine and emergency appointments when needed.

  • The practice used in-house surveys and the NHS Friends and Family test to obtain patients’ views.

  • Patients were positive about the service provided by the practice. They said this met their needs and that staff were reassuring, respectful and professional.

  • The practice had established governance processes to help them manage the service. The partners were investing in the practice and were in the process of improving the physical environment and facilities.

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

  • Review the storage of temperature sensitive dental care products and medicines to ensure they are stored in line with the manufacturer’s guidance and the refrigerator temperature is monitored and recorded.
  • Review the ease with which staff can access Glucagon, a medicine for patients needing urgent first aid for seriously lowered blood sugar.
  • Review the practice’s protocols for the use of a rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society
  • Review the practice’s X-ray audits to ensure all of the expected aspects of radiography are included.
Inspection areas

Safe

No action required

Updated 4 July 2016

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

The practice was motivated to provide a safe service and had systems for managing this. These included policies and procedures for important aspects of health and safety such as infection prevention and control, clinical waste management, dealing with medical emergencies, maintenance and testing of equipment, dental radiography (X-rays) and fire safety. Staff were knowledgeable about their responsibilities for safeguarding children and adults and took this seriously. Contact information for local safeguarding professionals and relevant policies and procedures were readily available for staff to refer to if needed. The practice was in the process of setting up a new decontamination room, had installed new dental treatment chairs and were about to replace the flooring in the two treatment rooms.

Effective

No action required

Updated 4 July 2016

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

The practice provided personalised dental care and treatment. The dental care records we looked at provided clear and detailed information about patients’ care and treatment. Clinical staff were registered with the General Dental Council and completed continuous professional development to meet the requirements of their professional registration. The information we gathered confirmed that the care and treatment provided reflected published guidance although one dentist did not always use a rubber dam for root canal treatment in line with national guidance. Staff understood the importance of obtaining informed consent. The dentists were aware of the importance of taking the Mental Capacity Act 2005 into account when considering whether patients were able to make their own decisions.

Caring

No action required

Updated 4 July 2016

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

We gathered patients’ views from 27 completed Care Quality Commission comment cards and looked at the practice’s own surveys and NHS Friends and Family test results for the last 12 months. These provided a consistently positive view of the practice and the care and treatment patients received. Patients described the whole practice team as caring, friendly, reassuring and efficient. Several patients commented on how well the dentists explained their treatment they needed and the effort they took to make sure they understood. The NHS Friends and Family test results showed that from a total of 408 responses, 316 patients said they were extremely likely to recommend the service and 80 were likely to recommend it. 

Responsive

No action required

Updated 4 July 2016

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

All the feedback we looked at from patients showed high levels of satisfaction with the practice and confirmed that they received a personalised service that met their needs.

The areas of the practice used by patients were mostly at ground level and the waiting room had sufficient space for patients using wheelchairs. One treatment room had two steps from the waiting room. The practice had acted on patient feedback and improved the steps and handrails to this treatment room. Staff told us that they booked appointments in the ground floor treatment room for patients unable to manage these steps. All the information we reviewed showed that patients could obtain routine treatment and urgent or emergency care when they needed and were satisfied with the time they waited for an appointment.

Information was available for patients at the practice. The practice had a complaints procedure which was available for patients and they responded to complaints promptly in accordance with their policy and national guidance.

Well-led

No action required

Updated 4 July 2016

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

The practice had had arrangements for managing and monitoring the quality of the service. These included relevant policies, systems and processes which were available to all staff. The practice carried out audits which they followed up with action plans to help them monitor and improve the quality of the service provided. The partners were investing in the practice by making improvements to the physical environment, facilities and equipment.

The practice team were positive about using learning and development to maintain and improve the quality of the service. There was an appraisal process for all staff and the practice held regular staff meetings.

The practice took the views of patients seriously and used their own surveys and the NHS Friends and Family test to obtain feedback.