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Inspection Summary


Overall summary & rating

Updated 9 February 2017

We carried out an unannounced comprehensive inspection on 5 January 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

Cripps Dental Centre is located in ground floor premises situated on the university campus in Nottingham. There are seven treatment rooms. The practice provides a mixture of private and NHS treatment (a 50/50 split). There is free car parking for one hour for dental patients outside the practice.

The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are – Monday: 8 am to 7:30 pm; Tuesday to Thursday: 8 am to 5:30 pm; Friday 8am to 4:30 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients can telephone the NHS 111 telephone number.

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.

The practice has seven dentists; one part time orthodontist; two hygienists; nine qualified dental nurses; four trainee dental nurses; a reception team; an administration team and one practice manager.

During the inspection the practice gave out CQC comments cards for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received responses from 17 patients through both comment cards and by speaking with them during the inspection. Those patients provided positive feedback about the services the practice provides.

Our key findings were:

  • The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
  • The systems to record accidents, significant events and complaints, learning points from these were recorded and used to make improvements.
  • Staff had been trained to recognise and report on safeguarding issues relating to children and vulnerable adults.
  • Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • There were effective systems at the practice related to the Control of Substance Hazardous to Health (COSHH) Regulations 2002.
  • Patients said they had no problem getting an appointment that suited their needs.
  • Patients were able to access emergency treatment when they were in pain.
  • Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect.
  • Patients’ confidentiality was protected within the practice.
  • The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
  • The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
  • There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns about a colleague’s practice.
  • The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.
Inspection areas

Safe

No action required

Updated 9 February 2017

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

The systems for recording accidents, incidents and complaints were robust.

All staff had received up-to-date training in safeguarding vulnerable adults and children. There were clear guidelines for reporting concerns and the practice had a lead member of staff to offer support and guidance over safeguarding matters. Staff knew how to recognise the signs of abuse, and how to raise concerns when necessary.

There were effective systems at the practice related to the Control of Substance Hazardous to Health (COSHH) Regulations 2002.

The practice had emergency medicines and oxygen available, and an automated external defibrillator (AED). Regular checks were being completed to ensure the emergency equipment was in good working order.

Recruitment checks were completed on all new members of staff. This was to ensure staff were suitable and appropriately qualified and experienced to carry out their role.

The practice was visibly clean and had infection control procedures to ensure that patients were protected from potential risks. Regular audits of the decontamination process were as recommended by the current guidance.

X-ray equipment was regularly serviced to make sure it was safe for use.

Effective

No action required

Updated 9 February 2017

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

All patients were clinically assessed by a dentist before any treatment began. The practice used a recognised assessment process to identify any potential areas of concern in a patient’s mouth including their soft tissues (gums, cheeks and tongue).

The practice was following National Institute for Health and Care Excellence (NICE) guidelines for the care and treatment of dental patients. Particularly in respect of patient recalls, lower wisdom tooth removal and the prescribing of antibiotics for patients at risk of infective endocarditis (a condition that affects the heart).

The practice had systems in place for making referrals to other dental professionals when it was clinically necessary.

Caring

No action required

Updated 9 February 2017

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

the relevant regulations.

Patient confidentiality was maintained and electronic dental care records were password protected.

Feedback from patients identified staff were friendly, and treated patients with care and concern. Patients also said they were treated with dignity and respect.

There were systems for patients to be able to express their views and opinions.

Responsive

No action required

Updated 9 February 2017

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

Patients who were in pain or in need of urgent treatment could usually get an appointment the same day. There were arrangements for emergency dental treatment outside of normal working hours, including weekends and public holidays

Patient areas including treatment rooms were all located on the ground floor which allowed easy access for patients with restricted mobility. The practice had an induction hearing loop to assist patients who used a hearing aid.

Interpreters were readily available for patients whose first language was not English. There were clear instructions for staff in how to book interpreters and ensure patients’ needs were met.

There were systems and processes to support patients to make formal complaints. Where complaints had been made these were acted upon, and apologies given when necessary.

Well-led

No action required

Updated 9 February 2017

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

There was a clear management structure at the practice. Staff were aware of their roles and responsibilities within the dental team, and knew who to speak with if they had any concerns. Staff said they felt well supported and there were systems for peer review and clinical discussion.

The practice had a system for carrying out regular audits of both clinical and non-clinical areas to assess the safety and effectiveness of the services provided. However, action plans from audits where improvements were needed were not always produced.

Patients were able to express their views and comments, and the practice listened to those views and acted upon them.