Archived: Dental Care Direct - Lexicon House

We carried out an announced comprehensive inspection on 28 November 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

Dental Care Direct - Lexicon House is situated in Leeds, West Yorkshire. It shares a building with an out of hours medical centre. The practice provides urgent dental care through the NHS 111 service; routine dental care is not provided. Dental Care Direct is a subsidiary of Local Care Direct.

The practice has two surgeries, a decontamination room, a waiting area and a reception area. All of the facilities and patient toilets are on the ground floor of the premises.

There are 36 dentists, 17 qualified dental nurses and seven receptionists who take part in the provision of the service. They are also supported by a practice manager and an administrative team which includes a safeguarding lead, an infection control lead, a support services manager, a head of workforce and the dental services director.

The opening hours are 8-30am to 10-30pm seven days a week. The booking hub is open between 7-00am and 11-00pm.

The practice manager 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.

During the inspection we received feedback from 16 patients. The patients were positive about the care and treatment they received at the practice. Comments included staff were friendly, kind and courteous. They also commented the service was efficient and their needs were met.

Our key findings were:

• The practice was visibly clean and uncluttered.
• The practice had some systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies. The practice should implement more dental specific risk assessments.
• Staff were qualified and had received training appropriate to their roles.
• The recruitment process required improvement as Disclosure and Barring Service checks were not sought at the point of employment for the dentists.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including any risks.
• Dental care records showed treatment was planned in line with current best practice guidelines.
• We observed patients were treated with kindness and respect by staff.
• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
• There was an effective process in place to contact patients to make an appointment.
• Patients were triaged and given an appointment appropriate to their individual needs.
• The practice had daily dedicated slots available for children in pain.
• The governance systems were effective but should be made more specific for the dental environment.
• There were clearly defined leadership roles within the practice and staff told us they felt supported, appreciated and comfortable to raise concerns or make suggestions.
• The practice regularly audited both clinical and non-clinical areas of work.

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

• Review the practice’s governance arrangements ensuring policies and risk assessments are specific to the dental sector.
• Review the practice’s system for sharing the learning from significant events.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review the practice’s waste handling policy and procedure to ensure waste is segregated and disposed of in accordance with relevant regulations giving due regard to guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• Review the practice's recruitment policy and procedures to ensure Disclosure and Barring Service (DBS) checks are carried out at the point of employment.