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Inspection Summary


Overall summary & rating

Updated 10 May 2017

We carried out this announced inspection on 12 April 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 Cheshire and Merseyside area team that we were inspecting the practice. We did not receive any information of concern from them.

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

Rice Lane Dental Practice is situated in a residential suburb of Liverpool, and provides NHS and privately funded treatment to patients of all ages.

There are steps at the front entrance to the practice with a handrail positioned alongside to assist patients. Car parking is available near the practice.

The dental team includes two dentists, a dental hygienist, a dental hygiene therapist, eight dental nurses, one of whom is a trainee, and two of whom also carry out reception duties. The practice has three treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

We received feedback from 38 people during the inspection about the services provided. The feedback provided was positive about the practice.

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

The practice is open: Monday and Tuesday 9.00am to 6.00pm, Wednesday 9.00am to 5.30pm, Thursday 9.00am to 5.00pm, and Friday 9.00am to 3.30pm.

Our key findings were:

  • The practice was clean and well maintained.
  • The practice had infection control procedures in place which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medical emergency medicines and equipment were available.
  • The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
  • Staff provided patients’ care and treatment in line with current guidelines.
  • The practice had a procedure in place for dealing with complaints.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
  • The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
  • The practice asked patients and staff for feedback about the services they provided.
  • The practice had systems in place to help them manage most risks at the practice, but the procedures relating to staff immunisation were not robust.
  • The practice had staff recruitment procedures in place. Minor improvements were needed.

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

  • Review the system to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities, specifically in relation to staff working in a clinical environment where the effectiveness of the Hepatitis B vaccination is not known.
  • Review the practice's recruitment policy and procedures to ensure references for new staff are requested and recorded suitably.
  • Review the security of NHS prescriptions in the practice to ensure they are all monitored and tracked.
  • Introduce a system to ensure staff are up to date with training and their continuing professional development.
Inspection areas

Safe

No action required

Updated 10 May 2017

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

The practice had systems and processes in place to provide safe care and treatment. They used learning from incidents and complaints to help them improve.

The practice had robust safeguarding procedures in place. Staff received training in safeguarding and knew how to recognise the signs of abuse and how to report concerns.

We found the equipment used in the practice was well maintained and tested at regular intervals.

The premises were secure and well maintained. The practice was cleaned regularly.

The practice had suitable arrangements for dealing with medical and other emergencies.

Staff were qualified for their roles, where necessary. The practice completed essential recruitment checks but recruitment procedures needed minor improvements. The provider assured us this would be addressed.

The practice had arrangements in place to manage risk but risks had not been assessed in relation to staff immunisation. The provider assured us this would be addressed.

NHS prescription pads were securely stored but improvements were needed to monitoring their use. The provider assured us this would be addressed.

Effective

No action required

Updated 10 May 2017

We found that this practice was providing effective care in accordance with

the relevant regulations.

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as excellent. The dentists discussed treatment with patients so they could give informed consent and recorded this in their records.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

The practice supported staff to complete training relevant to their roles but did not have a system in place to monitor this.

The provider assured us this would be addressed.

Caring

No action required

Updated 10 May 2017

We found that this practice was providing caring services in accordance with

the relevant regulations.

Patients were positive about all aspects of the service. They told us staff were caring, friendly and welcoming. They said that they were given helpful, honest explanations about dental treatment and options, and that the dentists listened to them. Patients commented that staff made them feel at ease, especially when they were anxious about visiting the dentist.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality.

Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 10 May 2017

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

The practice’s appointment system took account of patients’ needs. Patients could obtain an appointment quickly in an emergency.

The practice considered patients’ individual needs and made reasonable adjustments to meet these. This included providing facilities for patients with disabilities and families with children. The practice had access to interpreter services and made arrangements to help patients who had sight or hearing loss.

Staff responded to concerns and complaints quickly.

Well-led

No action required

Updated 10 May 2017

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

The practice had arrangements in place to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided.

There was a clearly defined management structure and staff felt supported and appreciated.

The practice team kept accurate patient dental care records which were stored securely.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.