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Inspection Summary


Overall summary & rating

Updated 11 October 2016

We carried out an announced comprehensive inspection on 25 August 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

The practice is located in premises close to Hitchin town centre in north Hertfordshire. There is a small car park to the rear of the practice otherwise there is roadside parking or pay and display car parking available in and around the town centre. There are four treatment rooms all of which are located on the ground floor. The practice has four dental chairs registered with the Care Quality Commission.

The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment. The practice provides mostly NHS dental treatments.

The practice’s opening hours are – Monday to Thursday: 8:30 am to 5 pm; Friday: 8:30 am to 2 pm. Some Saturdays: 9:30 am to 1:30 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message which direct patients to telephone the NHS 111 telephone number.

The principal dentist 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 six dentists plus one dentist with a special interest in endodontics (specialising in the inside of the tooth); one specialist periodontist (a branch of dentistry concerned with the structures surrounding and supporting the teeth); one dentist specialising in implants; one dental hygienist; four qualified dental nurses; two trainee dental nurses; and a head receptionist. All staff at the practice worked on a part-time basis.

We received positive feedback from 24 patients about the services provided. This was by speaking with patients in the practice and through CQC comment cards left at the practice prior to the inspection.

Our key findings were:

  • Patients at the practice and through CQC comment cards provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect.
  • The practice was well equipped.
  • Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Dentists identified the different treatment options, and discussed these with patients.
  • Patients’ confidentiality was maintained.
  • The practice was visibly clean and tidy.
  • The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
  • There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns.
  • The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.

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

  • Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 by carrying out an access audit for the premises. In addition, consider installing a hearing induction loop to assist patients who have difficulties with hearing.

Inspection areas

Safe

No action required

Updated 11 October 2016

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

The practice was visibly clean.

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. Staff knew how to recognise the signs of abuse, and how to raise concerns when necessary.

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

Recruitment checks were completed on all new members of staff. This was 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.

X-ray equipment was regularly serviced to make sure it was safe for use.

Effective

No action required

Updated 11 October 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. The practice used a recognised assessment process to identify any potential areas of concern in a patient’s mouth 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 patient recalls, lower wisdom tooth removal and the prescribing of antibiotics for patients at risk of infective endocarditis (a condition that affects the heart).

The practice had systems in place for making referrals to other dental professional when it was clinically necessary.

Caring

No action required

Updated 11 October 2016

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

the relevant regulations.

Patient confidentiality was maintained and protected.

Feedback from patients identified staff were friendly, welcoming and professional. Feedback indicated that the practice treated patients with dignity and respect.

There were systems for patients to be able to express their views and opinions.

Responsive

No action required

Updated 11 October 2016

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

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

The practice was located on the ground floor. A disabled access audit in line with the Equality Act (2010) had been completed to consider the needs of patients with restricted mobility. The practice did not have an induction hearing loop to assist patients who used a hearing aid.

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 the practice leaflet.

There were systems and processes to support patients to make formal complaints. Where complaints had been made these were acted upon, and apologies given when necessary.

Well-led

No action required

Updated 11 October 2016

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

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 had a system for carrying out regular audits of both clinical and non-clinical areas to assess the safety and effectiveness of the services provided. Policies and procedures had been kept under review.

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 a senior colleague if they had any concerns.