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Cromwell Dental Practice Limited

Inspection Summary


Overall summary & rating

Updated 21 April 2017

We carried out an announced comprehensive inspection on 13 March 2017 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

Cromwell Dental Practice Limited is situated in Grimsby, Lincolnshire. The practice provides dental treatment to adults and children on an NHS or privately funded basis. The services include preventative advice and treatment and routine restorative dental care.

The practice is situated in a medical centre and has four surgeries, a decontamination room, a waiting area and a reception area. All of the facilities are on the ground floor of the premises along with accessible toilet facilities.

There are four dentists, one dental hygiene therapist, five dental nurses, two receptionists and a practice manager. On the day of inspection the practice manager was not able to attend.

The opening hours are Monday, Thursday and Friday from 8:30am to 5:30pm, Tuesday from 8:30am to 6:30pm and Wednesday from 8:30am to 5:00pm.

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 seven patients. The patients were positive about the care and treatment they received at the practice. Comments included staff were caring, attentive and helpful. They also commented they were able to make appointments which suited their needs and the premises were clean and tidy.

Our key findings were:

  • The practice was visibly clean and uncluttered.
  • The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
  • The system for identifying significant events and disseminating information required improvement.
  • Staff were qualified and had received training appropriate to their roles.
  • Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
  • Dental care records showed treatment was planned in line with current best practice guidelines.
  • Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
  • 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 were clearly defined leadership roles and staff told us they felt supported, appreciated and comfortable to raise concerns or make suggestions.

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

  • Review the practice’s system for recording and disseminating information from incidents or 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 process for checking Hepatitis B immunisation status at the point of employment.
  • Review the practice’s process for acting on recommendation from routine tests of the X-ray machines.
  • Review the frequency of staff meetings and they availability of meeting minutes.
Inspection areas

Safe

No action required

Updated 21 April 2017

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

The system for reporting of significant events and incidents was not effective. These were not always reported or disseminated to staff.

Staff had received training in safeguarding at the appropriate level and knew the signs of abuse and who to report them to.

Staff were suitably qualified for their roles and the practice had undertaken the relevant recruitment checks to ensure patient safety. The practice did not always check the Hepatitis B status of clinical staff prior to employment.

Staff were trained to deal with medical emergencies. All emergency equipment and medicines were in date and in accordance with the British National Formulary (BNF) and Resuscitation Council UK guidelines.

The decontamination procedures were effective and the equipment involved in the decontamination process was regularly serviced, validated and checked to ensure it was safe to use.

X-ray equipment had been tested according to manufacturer’s guidance. The recommendations from the tests had not been implemented.

Effective

No action required

Updated 21 April 2017

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

Patients’ dental care records provided comprehensive information about their current dental needs and past treatment. The practice monitored any changes to the patient’s oral health and provided treatment when appropriate.

The practice followed best practice guidelines when delivering dental care.

Staff provided tailored oral health advice to patients and this was supported by a variety of written and visual information for patients to refer to.

Staff were encouraged to complete training relevant to their roles and this was monitored by the practice manager. The clinical staff were up to date with their continuing professional development (CPD).

Referrals were made to secondary care services if the treatment required was not provided by the practice.

Caring

No action required

Updated 21 April 2017

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

During the inspection we received feedback from seven patients. The patients commented that caring, attentive and helpful.

We observed the staff to be welcoming and caring towards the patients.

We observed privacy and confidentiality were maintained for patients using the service on the day of the inspection.

Staff explained that enough time was allocated in order to ensure that the treatment and care was fully explained to patients in a way which they understood.

Responsive

No action required

Updated 21 April 2017

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

The practice had an efficient appointment system in place to respond to patients’ needs. Patients commented they could access treatment for urgent and emergency care when required. There were clear instructions for patients requiring urgent care when the practice was closed.

There was a procedure in place for responding to patients’ complaints. This involved acknowledging, investigating and responding to individual complaints or concerns. Staff were familiar with the complaints procedure.

The practice had made reasonable adjustments to enable wheelchair users or patients with limited mobility to access treatment.

Well-led

No action required

Updated 21 April 2017

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

There was a clearly defined management structure in place and all staff felt supported and appreciated in their own particular roles. The practice manager was responsible for the day to day running of the practice.

Practice meetings were sporadic and infrequent.

The practice regularly audited clinical and non-clinical areas as part of a system of continuous improvement and learning.

They conducted quarterly patient satisfaction surveys, were currently undertaking the NHS Friends and Family Test (FFT) and there was a comments box in the waiting room for patients to make suggestions to the practice.