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Inspection Summary

Overall summary & rating

Updated 18 April 2018

We carried out this focused inspection of Oak Tree Dental Practice to follow up concerns we originally identified during a comprehensive inspection at the practice on 28 September 2016 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

At a comprehensive inspection we always ask the following five questions to get to the heart of patients’ experiences of care and treatment:

  • Is it safe?
  • Is it effective?
  • Is it caring?
  • Is it responsive to people’s needs?
  • Is it well-led?

When one or more of the five questions is not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

At the previous comprehensive inspection, we found the registered provider was providing safe, effective, caring and responsive care in accordance with relevant regulations. We judged the practice was not providing well-led care in accordance with Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Oak Tree Dental Practice on our website

This inspection was carried out on 27 February 2018 by a review of documents and other evidence sent to us from the provider as requested at our previous inspection.

We also reviewed the key questions of safe and effective as we had made recommendations for the provider relating to these key questions. We noted that some improvements had been made.

Our findings were:

Are services well-led?

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

The provider had made adequate improvement to put right the shortfalls and deal with the regulatory breach we found at our inspection on 28 September 2016. The provider must ensure that the newly implemented improvements are embedded and sustained long-term in the practice.

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

  • Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

Inspection areas


No action required

Updated 26 January 2017

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

Systems were in place for recording significant events and accidents. Staff were aware of the procedure to follow to report incidents, accidents and Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) regarding staff at the practice Information recorded in accident records was brief and did not detail any action taken or learning.

Medicines for use in an emergency were available and emergency medical equipment was also available. Documentation was available to demonstrate that monthly checks were being made to ensure equipment was in good working order and medicines were within their expiry date. However the frequency of these checks was not in line with the Resuscitation Council (UK) guidance. Three staff required update training in responding to a medical emergency.

There were sufficient numbers of suitably qualified staff working at the practice. Staff had received safeguarding training and were aware of their responsibilities regarding safeguarding children and vulnerable adults.

Infection control audits were being undertaken on a six monthly basis in accordance with the recommendations of HTM 01-05. The practice had systems in place for waste disposal and on the day of inspection the practice was visibly clean and clutter free.


No action required

Updated 26 January 2017

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

The dental care provided was evidence based and focussed on the needs of the patients. The practice used current national professional guidance including that from the National Institute for Health and Care Excellence (NICE) to guide their practice. There were clear procedures for referring patients to secondary care (hospital or other dental professionals). Referrals were made in a timely way to ensure patients’ oral health did not suffer.

The practice used oral screening tools to identify oral disease. Patients and staff told us that explanations about treatment options and oral health were given to patients in a way they understood and risks, benefits, options and costs were explained. Patients’ dental care records did not demonstrate this on each occasion.

Staff received professional training and development appropriate to their roles and learning needs. Staff were registered with the General Dental Council (GDC) and were meeting the requirements of their professional registration.


No action required

Updated 26 January 2017

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

We observed privacy and confidentiality were maintained for patients using the service on the day of the inspection. Staff treated patients with kindness and respect and were aware of the importance of confidentiality. Feedback from patients was overwhelmingly positive. Patients praised the staff and the service and treatment received. Patients commented that staff were professional, friendly and helpful.


No action required

Updated 26 January 2017

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

Patients had good access to treatment and urgent care when required. The practice had ground floor treatment rooms and toilet which had been adapted to meet the needs of patients with a disability. Level access was provided into the rear of the building for patients with mobility difficulties and families with prams and pushchairs.

The practice had developed a complaints procedure and information about how to make a complaint was available for patients to reference.


No action required

Updated 18 April 2018

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

The provider had made improvements to the management of the service. This included implementing a system for recording and learning from accidents and incidents, ensuring staff received CPR training and monitoring emergency medical equipment and medicines in line with resuscitation council guidelines. Fire safety equipment was serviced, maintained and monitored on a regular basis; fire marshal training has been completed by a member of staff in line with the requirements of the practice’s fire risk assessment. Infection control issues identified have been addressed; quarterly foil tests were completed for the ultrasonic cleaner and drawer handles in the decontamination room have been replaced. The practice were using a pre-employment checklist and a pre-employment medical questionnaire is being completed by staff upon employment at the practice.

The provider had failed to address a minor issue we had raised in our previous report; the provider must ensure action is taken to address all outstanding issues.