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Inspection Summary


Overall summary & rating

Updated 26 November 2015

We carried out an announced comprehensive inspection on 22 October 2015 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 Oakmead Dental Care practice is located in the London Borough of Bromley. The premises are situated in a split-level, purpose-built building. There are five treatment rooms, a dedicated decontamination room, a waiting room with reception area, staff room, administrative office, and two toilets.

The practice provides private services to adults and NHS dental services for children. The practice offers a range of dental services including routine examinations and treatment, veneers, crowns and bridges, implants, and oral hygiene. The practice also offers intravenous conscious sedation for some treatments.

The staff structure of the practice is comprised of a principal dentist (who is also the owner), three associate dentists, six dental nurses, a trainee dental nurse, five receptionists, and two hygienists, one of whom also works as the practice manager.

The practice opening hours are on Monday from 8.00am to 7.30pm, Tuesday from 8.00 am to 7.00pm, Wednesday from 8.30am to 8.00pm, Thursday from 10.00am to 8.00pm, Friday from 8.00am to 5.30pm, and Saturday from 9.00am to 1.00pm.

The principal dentist is the registered manager. A registered manager is a person who is registered with the CQC 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 inspection took place over one day and was carried out by a CQC inspector and dentist specialist advisor.

Twelve people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

  • Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

  • There were effective systems in place to reduce and minimise the risk and spread of infection.

  • The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.

  • Staff reported incidents and kept records of these which the practice used for shared learning.

  • Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.

  • Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.

  • The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

  • The practice had implemented clear procedures for managing comments, concerns or complaints.

  • The principal dentist had a clear vision for the practice and staff told us they were well supported by the management team.

  • Governance arrangements and audits were effective in improving the quality and safety of the services.

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

  • Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

  • Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
  • Review the protocol for sharing and learning from complaints with a view to preventing a recurrence of any problems.
Inspection areas

Safe

No action required

Updated 26 November 2015

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

The practice had systems in place to minimise the risks associated with providing dental services. There was a safeguarding lead and staff understood their responsibilities in terms of identifying and reporting any potential abuse. The practice had policies and protocols, which staff were following, for the management of infection control and medical emergencies. There were systems in place for identifying, investigating and learning from incidents relating to the safety of patients and staff members. We found the equipment used in the practice was well maintained and checked for effectiveness.

There were some areas where improvements could be made to safety systems. For example, an automated external defibrillator (AED) for exclusive use by the practice in medical emergencies could be considered. Risk assessments for the safe use of sharps and the need for a Disclosure and Barring Service check in non-clinical staff should also be in place.

Effective

No action required

Updated 26 November 2015

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

The practice could demonstrate they followed relevant guidance, for example, issued by the National Institute for Health and Care Excellence (NICE). The practice monitored patients’ oral health and gave appropriate health promotion advice. The practice maintained appropriate dental care records and details were updated appropriately. The practice worked well with other providers and followed patients up to ensure that they received treatment in good time.

Clinical staff worked towards meeting professional standards and completing continuing professional development (CPD) standards set by the General Dental Council (GDC). Staff told us they were well-supported by the principal dentist through informal supervision and ad hoc staff meetings.

Caring

No action required

Updated 26 November 2015

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

We received positive feedback from patients through comment cards. Patients felt that the staff were kind and caring; they told us that they were treated with dignity and respect at all times. We found that patient confidentiality was well maintained. There were plans in place for improving the security of dental care records through the installation of new, lockable filing cabinets.

Responsive

No action required

Updated 26 November 2015

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

Patients had good access to appointments, including emergency appointments, which were available on the same day. Patients were invited to provide feedback via a satisfaction survey and the results of these surveys had been analysed and acted on.

There was a complaints policy which was displayed in the waiting room. Three complaints had been received by the practice in the past year. The practice manager had followed the complaints policy and had carried out relevant investigations and recorded the outcome of these. The practice could take further action to disseminate the outcomes of these investigations among staff with a view to preventing a recurrence of any problems.

Well-led

No action required

Updated 26 November 2015

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

The practice had clinical governance and risk management protocols in place. These were disseminated effectively to all members of staff. A system of audits was used to monitor and improve performance. Staff described an open and transparent culture where they were comfortable raising and discussing concerns with the principal dentist. Feedback from staff and patients was used to monitor and drive improvement in standards of care.