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Inspection Summary


Overall summary & rating

Updated 23 January 2019

We undertook a follow up focused inspection of Photay and Associates - Long Lane. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Photay and Associates - Long Lane on

24 April 2018under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care in accordance with the relevant regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Photay and Associates - Long Lane dental practice on our website www.cqc.org.uk.

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

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

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 24 April 2018.

Background

Photay and Associates - Long Lane is in Bexleyheath and provides NHS and private treatment to adults and children.

The dental team includes two dentists, a clinical dental technician, a qualified dental nurse, a trainee dental nurse, and a practice manager. The dental nurses also undertake receptionist duties. The practice has a treatment room on the ground floor of the premises.

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 the practice was one of the partners.

The practice is open from 9am to 5pm Monday to Friday.

Our key findings were:

At the previous inspection we found this practice was providing safe care in accordance with the relevant regulations but told them there were things they should do. We found that the provider had taken action to address the issues we said they should look at. We found that:

•Clinical staff had adequate immunity for vaccine for preventable infectious diseases.

• The practice had protocols for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.

• Staff were aware of their responsibilities in relation to the Control of Substances Hazardous to Health (COSHH), the Reporting of Incidents Diseases and Dangerous Occurrences (RIDDOR), safety alerts, safeguarding leads, the mental Capacity Act and consent for under 16s.

• The practice’s system for documentation of actions taken, and learning shared, in response to

incidents with a view to preventing further occurrences and ensuring improvements are made as a result.

At the previous inspection we found this practice was providing effective care in accordance with the relevant regulations but told them there were things they should do. We found that the provider had taken action to address the issues we said they should look at. We found that:

• Prescription pads were locked away securely in a locked safe.

• The practice had protocols in place for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

• The practice had protocols for referral of patients to ensure all referrals are monitored suitably.

• The practice was generally clean and well maintained but some improvements were required. For example, in regard to the cleaning of walls and skirting in the decontamination room.

At the previous inspection we found this practice was providing responsive care in accordance with the relevant regulations but told them there were things they should do. We found that the provider had taken action to address the issues we said they should look at. We found that:

• Arrangements had been agreed by the practice to ensure the availability of interpreter services for patients who do not speak or understand English as a first language. This would be done by on line interpretation services.

• The practice had adequate staff recruitment procedures.

• The practice had effective leadership and culture of continuous improvement.

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

  • Review the practice’s systems in place for environmental cleaning taking into account current national guidelines.
  • Review its responsibilities to respond to meet the needs of patients with disability and the requirements of the Equality Act 2010.
Inspection areas

Safe

No action required

Updated 14 June 2018

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.

The practice had systems and processes to provide safe care and treatment.

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.

The majority of the premises was clean and most equipment properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

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

Effective

No action required

Updated 14 June 2018

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. The dentists discussed treatment with patients so they could give informed consent.

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

The practice supported staff to complete training relevant to their roles.

Caring

No action required

Updated 14 June 2018

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

We received feedback about the practice from four people. Patients were positive about all aspects of the service the practice provided. They told us staff were attentive, respectful and professional. The provider used learning from complaints to help them improve.

Patients commented that they were given clear explanations about their treatment and said their dentist listened to them. Patients commented that they made them feel comfortable.

During the inspection we observed that staff protected patients’ privacy and were aware of the importance of confidentiality.

Responsive

No action required

Updated 14 June 2018

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.

The practice took patients’ views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 23 January 2019

We found that this practice was providing well-led care in accordance with

the relevant regulations.

The provider had made improvements to the management of the service.

The practice had arrangements to ensure the smooth running of the service. These included systems to assess, monitor and discuss the quality and safety of the care and treatment provided.

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