Life Dental & Wellbeing

We carried out this announced inspection on 9 August 2017 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. NHS England provided us with information about the contract they hold with the practice. Healthwatch did not provide any information.

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

Life Dental & Wellbeing is in Exeter and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available near the practice.

The dental team includes two dentists, three dental nurses, two dental nurses/receptionists, one receptionist, one trainee dental nurse, two dental hygienists, one practice manager and one clinical manager/dental nurse. The practice has four treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Life Dental & Wellbeing was the principal dentist.

On the day of inspection we collected five CQC comment cards and 59 on-line CQC feedback forms, filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, two dental nurses, two dental nurses/receptionists, one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Mon/Tue/Wed/Thu 8:30am – 6pm. Thurs 8:30am – 7pm. Sat 10am – 3pm. Sunday appointments are available by arrangement on request.

Our key findings were:

• The practice was clean.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• Improvements could be made to staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Improvements could be made to infection control procedures.
• The appointment system met patients’ needs.
• Improvements could be made to ensure all aspects of the premises and equipment are well maintained.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

We identified an area of notable practice.

• The practice had identified key areas of need within the local community and was providing outreach oral education services to primary schools and care homes. These projects had been running for three years. The aim was to tackle an identified problem of tooth decay in children and vulnerable adults locally. Dental nurses with oral health qualifications approached local primary schools and care homes to set up educational sessions to give oral health and hygiene advice. In the past 12 month these sessions reached out to 20 local primary schools and two care homes. Feedback about the educational events was sought through evaluation forms to help tailor future sessions to needs and to evaluate if staff working in schools and care homes felt more empowered to promote good oral health with children or care home residents. Feedback was positive. These initiatives showed a deep commitment to the promotion of oral health in the community.

There were areas where the provider could make improvements. They should:

• Review the suitability of the premises and ensure all parts are fit for the purpose for which they are being used. In particular with regard to the fire escape staircase to the rear of the property and to dental chairs.
• Review the practices’ infection control audit cycle and procedures, taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular with regard to audit, assessment of Legionella risk and effective management of air flow in the decontamination room.
• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.