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Inspection Summary


Overall summary & rating

Updated 22 March 2016

We carried out an announced comprehensive inspection on 4 February 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

Mydentist in Derby is situated over three floors of a building located just of the inner ring road in central Derby. The practice is part of a larger organisation with a corporate dental provider. The practice was registered with the Care Quality Commission (CQC) in January 2014. The practice provides regulated dental services to patients from a wide area of Derbyshire. This was because the practice’s location close to the centre of Derby and near the ring road made it relatively easy for patients to attend who were not from the immediate area. The practice provides mostly NHS dental treatment. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice is open: Monday to Thursday: 8:45 am to 5:30 pm, and Friday: 8:45 am to 5 pm. Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients should ring the 111 telephone number.

The practice has six dentists, one orthodontist, two dental hygienists, seven dental nurses, three of whom also worked on reception, one receptionist, two trainee dental nurses and one practice manager.

We received positive feedback from 37 patients about the services provided. This was through CQC comment cards left at the practice prior to the inspection and by speaking with patients in the practice.

Our key findings were:

  • There were systems in place to record accidents, significant events and complaints. There was a system to identify any learning points from them and these were shared with staff.
  • The records showed that apologies had been given for any concerns or upset that patients had experienced.
  • There was a whistleblowing policy and procedures which staff were aware of, and knew how to use them. All staff had access to the whistleblowing policy.
  • Feedback from patients about the dental services they received was positive.
  • Patients said they were treated with dignity and respect.
  • Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • There were a sufficient supply of the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. .
  • The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
  • Patients’ were involved in discussions about the planning and delivery of care and treatment. Patient recall intervals were in line with National Institute for Health and Care Excellence (NICE) guidance.
  • Treatment options were identified, explored and discussed with patients.
  • Patients’ confidentiality was maintained.

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

  • Replace the broken hearing loop as a reasonable addition as identified in the Equality Act (2010).
  • Review the Control of Substances Hazardous to Health (COSHH) file and ensure that this is up-to-date to comply with the COSHH Regulations 2002.
  • Review the usage of rubber dams to follow the guidelines from the British Endodontic Society. This would include recording in the patients’ care records when rubber dams have been used, and if not why not.

Review how feedback was given to patients on a regular basis following the Family & Friends test and the practice’s own survey.

Inspection areas

Safe

No action required

Updated 22 March 2016

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

Accidents and significant events were recorded and monitored. Learning points from any accidents or significant events were shared with staff.

The practice received Medicines and Healthcare products Regulatory Agency (MHRA) alerts and took appropriate action including sharing information with staff.

All staff had received up-to-date training in safeguarding vulnerable adults and children. There were clear guidelines for reporting concerns and the practice had a lead member of staff to offer support and guidance over safeguarding matters.

The practice had the necessary emergency equipment including an automated external defibrillator (AED) and oxygen. Regular checks were being completed to ensure the equipment was in good working order.

Recruitment checks were completed on all new members of staff to ensure staff were suitable and appropriately qualified and experienced to carry out their role.

The practice had infection control procedures to ensure that patients were protected from potential risks. Regular audits of the decontamination process were as recommended by the current guidance. Equipment used in the decontamination process was maintained by a specialist company and regular checks were carried out to ensure equipment was working properly and safely.

X-rays were carried out safely in line with published guidance, and X-ray equipment was regularly serviced to make sure it was safe for use.

Effective

No action required

Updated 22 March 2016

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

All patients were clinically assessed by a dentist before any treatment began. This included completing or updating a health questionnaire. There was a recognised assessment process to identify any potential areas of concern in patients’ mouths, jaws and neck, including their soft tissues (gums, cheeks and tongue).

The practice was following National Institute for Health and Care Excellence (NICE) guidelines for the care and treatment of dental patients. Particularly in respect of recalls, wisdom tooth removal and the prescribing of antibiotics for patients at risk of infective endocarditis (a condition that affects the heart).

There were clear procedures for referring patients to secondary care (hospital or other dental professionals). Staff were able to demonstrate that referrals had been made in a timely way when necessary.

Caring

No action required

Updated 22 March 2016

We found that this practice was providing caring services in accordance with

the relevant regulations.

Staff maintained patient confidentiality.

Patients were treated in a polite caring manner and with dignity and respect.

Staff at the practice were friendly and welcoming to patients.

Patients said they received good dental treatment and they were involved in discussions about their dental care. Patients said they were able to express their views and opinions.

Responsive

No action required

Updated 22 March 2016

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

Patients said they could easily get an appointment. Patients who were in pain or in need of urgent treatment were usually seen the same day.

The practice did not have ground floor treatment rooms. Therefore patients who could not manage the stairs were referred to a different dental practice.

There were arrangements for emergency dental treatment outside of normal working hours, including weekends and public holidays which were clearly displayed in the waiting room, and in the practice leaflet.

There were systems for patients to make formal complaints, and these were acted upon, and apologies given when necessary.

Well-led

No action required

Updated 22 March 2016

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

The practice was part of a larger corporate provider. There was a clear management structure at the practice. Staff were aware of their roles and responsibilities within the dental team, and knew who to speak with if they had any concerns.

The practice was carrying out regular audits of both clinical and non-clinical areas to assess the safety and effectiveness of the services provided.

Patients were able to express their views and comments, and the practice listened to those views and acted upon them.

Staff said the practice was a friendly place to work, and they could speak with the principal dentist if they had any concerns.