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Inspection Summary


Overall summary & rating

Updated 12 January 2017

We carried out an announced comprehensive inspection on 6 December 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

Marble Alley Dental Practice is a general dental practice situated in the Warwickshire town of Studley.

The practice has two dental treatment rooms and offers general dentistry to adults and children funded by the NHS or privately.

The practice has three dentists all of whom are family, a dental hygienist, dental nurse and trainee dental nurse supported by a practice manager and receptionist. They are currently seeking to employ a further dental nurse and trainee dental nurse.

The practice has expanded to involve the building next door to the original premises. At the time of the inspection most of the building work was complete, however plans were in place to address further areas of the premises over the coming year.

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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience. We received feedback from 56 patients. These provided a positive view of the services the practice provides. Patients commented on the quality of care, the polite and friendly nature of staff and the cleanliness of the practice.

Our key findings were:

  • The practice was visibly clean and mostly clutter free.

  • Comments from patients indicated that the staff were kind and caring and were skilled at putting nervous patients at ease.

  • Due to the demand in the local area a routine new patient appointment could be offered at the practice in two months following the initial enquiry.

  • The practice had policies in place to assist in the smooth running of the service.

  • The practice used national guidance in the care and treatment of patients.

  • The practice met the national guidance in decontamination of dental instruments however the illuminated magnifier used to identify if any visible contaminants remained following cleaning was not entirely fot for purpose. This was replaced following the inspection.

  • Risk assessments were in place to identify, monitor and mitigate risks arising from carrying out the regulated activities. Although the sharps risk assessment lacked detail and was replaced following the inspection.

  • Clinical audit was used as a tool to highlight areas where improvements could be made.

  • Patients commented that options for treatment were explained to them in detail and this was in evidence in the dental care records we were shown.

  • Staff demonstrated good knowledge and procedures in the process of consent.

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

  • Review arrangements for monitoring the 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 staff awareness of Gillick competency and ensure all staff are aware of their responsibilities.

  • Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
Inspection areas

Safe

No action required

Updated 12 January 2017

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

The practice had medicines and equipment to manage medical emergencies, although the oxygen was out of date. This was replaced following the inspection. Missing or old emergency equipment was also replaced following the inspection.

The practice was carrying out appropriate pre-employment checks on staff to ensure they employed fit and proper persons.

The practice had not effectively assessed the risk of sharps on the premises; however this was addressed immediately following the inspection.

Fire risk assessments completed by an external contractor had not highlighted any areas for improvement.

Equipment had been serviced and tested in line with manufacturers’ instructions and national guidance.

Effective

No action required

Updated 12 January 2017

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

The dentists used nationally recognised guidance in the care and treatment of patients.

A comprehensive screening of patients was carried out at check-up appointments, and included screening for gum disease.

The practice demonstrated good knowledge and systems in the process of consent, and this was evidenced by the dental care records. In discussions around children giving consent it was clear that although the principle was understood staff were less clear on how to apply this in practise.

Caring

No action required

Updated 12 January 2017

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

Comments from patients were overwhelmingly positive about the care and treatment they received.

Patients were involved in the decisions around their treatment and care.

Written treatment plans were given to patients for them to be able to consider their options.

Responsive

No action required

Updated 12 January 2017

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

The practice endeavored to see all emergency patients on the day they contacted the practice.

The practice offered evening appointments once a week with a dentist and dental hygienist to accommodate these patients with commitments during normal working hours.

The practice afforded wheelchair access to a ground floor surgery, although at the time of the inspection there was no access to a ground floor toilet.

Well-led

No action required

Updated 12 January 2017

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

Polices were available to assist in the smooth running of the service. These had all been reviewed in the year before our visit.

The practice used clinical audit as a tool to highlight areas where improvements could be made.

Staff had annual appraisals where their training needs were addressed and a personal development plan drawn up to reflect it.