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Tewkesbury House Dental Practice

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Updated 24 February 2017

We carried out an announced comprehensive inspection on 26th January 2017 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

Tewkesbury House Dental Practice is located in the centre of Tewkesbury and provides NHS and private treatment to patients of all ages. The practice consists of five treatment rooms, toilet facilities for patients and staff, a reception area, waiting areas, a staff room and an office.

The practice treats both adults and children. The practice offers routine examinations and treatment. There are seven dentists, two hygienists, five trainee dental nurses, two qualified dental nurses, three receptionists and a practice manager.

The practice’s opening hours are

8.00 to 20.00 on Monday

8.00 to 17.30 on Tuesday

8.00 to 20.00 on Wednesday

8.00 to 20.00 on Thursday

8.30 to 18.00 on Friday

Out of hours patients were directed to phone 111 who will direct them to the nearest dental access centre.

We carried out an announced, comprehensive inspection on 26th January 2017. The inspection was led by a CQC inspector who was accompanied by a specialist dental advisor.

Before the inspection we looked at the NHS Choices website. In the previous year there had been 21 comments about the practice which ranged from poor to excellent. The majority were positive and the overall rating was 4.5 stars. The practice had responded to all the comments on NHS Choices except one and they were in the process of responding to this one.

For this inspection 22 people provided feedback to us about the service. Patients were positive about the care they received from the practice. They were complimentary about the service offered which they said was very good and excellent. They told us that staff were professional, helpful, caring and friendly and the practice was clean and hygienic.

Our key findings were:

• Safe systems and processes were in place, including a lead for safeguarding and infection control.

• Staff recruitment policies were appropriate and most of the relevant checks were completed. Staff received relevant training.

• The practice had ensured that risk assessments were in place.

• The clinical equipment in the practice was appropriately maintained. The practice appeared visibly clean throughout.

•The process for decontamination of instruments followed relevant guidance.

• The practice maintained appropriate dental care records and patients’ clinical details were updated.

• Patients were provided with health promotion advice to promote good oral care.

• Written consent was obtained for dental treatment.

• The dentists were aware of the process to follow when a person lacked capacity to give consent to treatment.

• All feedback that we received from patients was positive; they reported that it was a caring and friendly service.

• There were arrangements for governance at the practice such as systems for auditing patient records, infection control and radiographs.

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

  • Review the use of the re-sheathing device for hypodermic needles to ensure that the risk of a sharps injury is minimised.

  • Review the recruitment procedures to ensure that two written references are obtained before new staff start work in the practice.

  • Review the arrangements for keeping recruitment records in the practice to ensure that the registered manager has full information about prospective staff including written references.

  • Review the arrangements for communication to include a hearing loop for patients with a hearing impairment.
Inspection areas

Safe

No action required

Updated 24 February 2017

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

There were appropriate systems for reporting incidents and for learning from incidents. Staff had received training about safeguarding adults and children. There were policies about safeguarding and whistleblowing and staff knew how to report any concerns.

There were also arrangements for dealing with foreseeable emergencies, for fire safety and for managing risks to patients and to staff. There was a business continuity plan. Hazardous substances were managed safely.

Most of the appropriate checks were being made to make sure staff were suitable to work with vulnerable people. However, references were not always obtained before staff started to work in the practice. The necessary medicines were in place. Equipment was regularly serviced. X-rays were dealt with safely.

The surgeries were fresh and clean and guidance about decontamination of instruments was being followed to reduce the risk of the spread of infection.

Effective

No action required

Updated 24 February 2017

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

The dentists took X-rays at appropriate intervals. The practice was checking the condition of the gums for every patient and they were checking for oral cancers. Patients completed medical history questionnaires and these were updated at each visit. The practice kept up to date with current guidelines and research. They promoted the maintenance of good oral health through information about effective tooth brushing. The dentists discussed health promotion with individual patients according to their needs.

The practice had sufficient staff to support the dentists. Staff received appropriate professional development and all of the expected training. Unqualified nurses were receiving appropriate support to achieve a qualification.

The practice had suitable arrangements for working with other health professionals and making appropriate referrals to ensure quality of care for their patients. Patients were asked for written consent to treatment. Patients told us that the dentists discussed options for treatment with them. The patient records recorded options for treatment to help patients to make decisions about their care. The dentists showed understanding about the Mental Capacity Act 2005 (MCA) and what they would do if an adult lacked the capacity to make particular decisions for themselves.

Caring

No action required

Updated 24 February 2017

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

Staff in the practice were polite and respectful when speaking to patients. Patients’ privacy was respected and treatment room doors were closed during consultations. The practice used an electronic record system and the computer screens in reception were shielded so that they could not be seen by patients.

Patients were positive about the care they received from the practice. They reported that staff were professional, helpful, caring and friendly. Patients told us that they were involved in decisions about their care and gave consent to treatment.

Responsive

No action required

Updated 24 February 2017

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

The practice had a system to schedule enough time to assess and meet patients’ needs. Patients said that they could get an appointment easily. Emergencies were usually fitted in on the day the patient contacted the practice. The practice actively sought feedback from patients on the care being delivered. There was a procedure about how to make a complaint and the process for investigation. We saw evidence that the practice responded to feedback made direct to the practice and made changes when necessary.

There was an equality and diversity policy and staff had received training about equality and diversity. There was information about translation services for people whose first language was not English. Some staff spoke different languages. There was level access for wheelchair users to two surgeries and there was a toilet with disabled access. There was no hearing loop system for patients who had a hearing impairment. 

Well-led

No action required

Updated 24 February 2017

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

The practice had set up systems for clinical governance such as audits of the infection control, record keeping and radiographs. The area manager conducted site visits to monitor the quality of the service. There were checks of equipment. The autoclave and compressor were serviced and there were daily checks of the autoclave.

The practice had a range of policies which were made available to staff.

The practice manager was the lead for the practice supported by more senior managers in the organisation. There was a whistleblowing policy and information for staff about the duty of candour and the need to be open if an incident occurred where a patient suffered harm. So far there had been no such incidents.

The practice manager held team meetings and discussions where staff discussed developments in the practice such as new policies and patient safety alerts. Staff were responsible for their own continuing professional development and kept this up to date.

The practice was seeking feedback from patients through patient satisfaction feedback forms and the NHS friends and family test. They responded to comments from patients on the NHS Choices website. They made improvements in response to the feedback.