You are here

Archived: Bromley Cross Dental Practice

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Updated 20 February 2018

We carried out this announced inspection on 11 January 2018 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 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

Bromley Cross Dental Practice is in Bolton and provides NHS and private treatment to adults and children.

There is level access to the ground floor surgeries for people who use wheelchairs and pushchairs. On street parking is available near the practice.

The dental team includes five dentists, seven dental nurses (two of whom are trainees), one dental hygienist, one dental hygiene therapist, two receptionists and a practice manager. The practice has five 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.

On the day of inspection we collected 40 CQC comment cards filled in by patients and spoke with five other patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, three dental nurses, the dental hygienist 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 to Friday 09:00 to 12:30 and 14:00 to 17:00

Our key findings were:

  • The practice was clean and well maintained.
  • The practice had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The practice had systems to help them manage risk.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had thorough 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.
  • The appointment system met patients’ needs.
  • 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.

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

  • Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.

  • Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.

  • Review the practice’s protocols for grading the quality of X-rays and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.

  • Review the practice's recruitment policy and procedures to ensure appropriate notes of verbal references for new staff and proof of identification are recorded, and appropriate checks of locum staff are carried out.
Inspection areas

Safe

No action required

Updated 20 February 2018

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

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

Staff received training in safeguarding and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed essential recruitment checks with the exception of verbal references which were not documented. The practice occasionally used locum dental nurse agencies. They did not ensure that appropriate checks were carried out on these staff. The practice manager told us they would discuss these checks with the locum agency before using the service again.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

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

COSHH risk assessments were not in place.

The practice stored and kept records of NHS prescription pads but did not have a system to identify if individual prescriptions were missing.

We saw evidence that the dentists justified and reported on the X-rays they took but not all of them graded their X-rays, this was discussed directly with the clinicians to review their process.

Effective

No action required

Updated 20 February 2018

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.

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 and had systems to help them monitor this.

Caring

No action required

Updated 20 February 2018

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

We received feedback about the practice from 45 people. Patients were positive about all aspects of the service the practice provided. They told us staff were friendly, helpful and professional. They said that they were given helpful, honest explanations about dental treatment, and said their dentist listened to them. Patients commented that they 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.

A quarterly newsletter was produced by the practice and copies of this were available in the waiting rooms.

Responsive

No action required

Updated 20 February 2018

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

The premises had been extended, renovated and was maintained to a high standard. Staff aimed to provide a comfortable, relaxing environment.

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. This included providing facilities for disabled patients and families with children. The patient toilet was located on the first floor of the property which was not accessible to wheelchair users, a handrail had been installed to assist patients with limited mobility.

They did not have access to interpreter/translation services. We discussed this with the dentists who told us this service used to be available but had been discontinued and they had tried to organise this locally.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 20 February 2018

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

During the inspection we found all staff were responsive to discussion and feedback to improve the practice.

The practice had arrangements 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 complete patient dental care records which were, clearly written or typed and 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.