We carried out an announced comprehensive inspection on 20 June 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 not providing well-led care in accordance with the relevant regulations
Background
Bottisham Dental Practice is situated in the village of Bottisham in a building adjacent to a GP practice. The service provides a range of dental services to NHS and private patients of all ages and has its own car park. The service has long outgrown the premises and plans to relocate to a newly refurbished building in 2017. The practice is situated on one level, has three dental treatment rooms, a decontamination room, a reception area and waiting area.
The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.
As part of the inspection, 17 patients provided feedback about the service. Patients said that the staff were caring and helpful to them, they were happy with the care and treatment they had received and that staff were very reassuring.
Our key findings were:
- Patients told us they were able to get an appointment when they needed one and the staff were kind and helpful.
- Information from completed CQC comments cards gave us a positive picture of a friendly, caring and professional service.
- Dentists provided dental care in accordance with current guidelines from the Faculty for General Dental Practice guidelines and the National Institute for Care Excellence (NICE).
- Staff had good access to training and were supported to develop their knowledge and expertise.
- There was appropriate equipment for staff to undertake their duties, and equipment was well maintained. However the medicines and equipment available for use in medical emergencies did not meet the guidelines issued by the resuscitation council (UK) or the British National Formulary (BNF) guidance for medical emergencies in dental practice.
- There were systems to promote the safe operation of the service although the reporting of accidents, incidents and significant events required a review.
- Feedback from patients was used to improve the service.
We identified regulations that were not being met and the provider must:
- Ensure the practice's recruitment process is in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held. This must include evidence of Disclosure and Barring service checks for relevant staff.
- Ensure there are systems and processes in place to identify, assess and manage risks in relation to the following:
- Medicines and equipment to manage medical emergencies are available in line with guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
- Prescription pads are stored securely in the practice and ensure that medicines supplied by the practice are labelled in accordance with The Medicines for Human Use Regulations 2012.
- Robust arrangements for managing patient safety alerts issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and for managing accidents, incidents and significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
- Robust procedures for the safe management of sharps giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
- The secure storage of dental care records.
You can see full details of the regulations not being met at the end of this report.
There were areas where the provider could make improvements and should:
- Review the practice’s protocols for the use of rubber dam for root canal treatment and the use of hypochlorite giving due regard to guidelines issued by the British Endodontic Society
- Review the cleaning process and management of heavily soiled dental equipment.
- Review the consent policy to ensure that consent is sought from legal guardians for children below the age of 16 years.
- Review the training for staff in relation to medical emergency scenarios.
- Review and implement a system to monitor progress with staff training to ensure this is completed in a timely manner.