Updated 27 September 2019
We carried out this announced inspection on 14 August 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
The practice is in Castle Donington, a small market town in Leicestershire. It provides NHS and private treatment to adults and children.
There is level access for people who use wheelchairs and those with pushchairs by using an entrance at the rear of the premises. Public car parking spaces are available on the road outside the practice. There are also free parking spaces available in car parks within close proximity to the practice.
The dental team includes six dentists, three dental nurses, one trainee dental nurse, two receptionists and a practice manager. The practice has three treatment rooms; one is on the ground floor.
The practice is registered as a partnership. At the time of inspection there was no registered manager in post as required as a condition of registration. A registered manager is legally responsible for the delivery of services for which the practice is registered. One of the principal dentists has made an application to undertake the role.
On the day of inspection, we collected 41 CQC comment cards filled in by patients.
During the inspection we spoke with three dentists, three dental nurses (including the trainee dental nurse), two receptionists and the practice manager. We looked at practice policies and procedures, patient feedback and other records about how the service is managed.
The practice is open: Monday and Thursday from 9am to 7pm, Tuesday, Wednesday and Friday from 9am to 5pm.
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 with exception of some sizes of oropharyngeal airways, a child size self-inflating bag with reservoir, clear face masks for self-inflating bag (only one adult size held) and a child oxygen face mask with reservoir and tubing. An order was placed for missing items the day after our inspection.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had thorough staff recruitment procedures, although they had not implemented a recruitment policy at the time of our inspection.
- The clinical staff provided patients’ care and treatment in line with current guidelines. We also found examples where guidance was not followed, for example, the use of rubber dam and basic periodontal examination (BPE). We were informed that processes were being strengthened after our inspection.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- 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:
- Take action to ensure dentists are aware of the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment .
- Take action to ensure the clinicians take into account the guidance provided by the Faculty of General Dental Practice when completing dental care records.
- Take action to ensure the clinicians carry out patient assessments and ensure they are in compliance with current legislation and take into account relevant nationally recognised evidence-based guidance.