We carried out this announced inspection on 10 March 2020 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 Care Quality Commission, (CQC), inspector who was supported by a specialist dental adviser.
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 this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found this practice was providing effective care in accordance with the relevant regulations.
Are services caring?
We found this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found this practice was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
Chagford Dental Practice is in Chagford and provides private dental care, mainly to adults, with some families receiving dental care.
The building is Grade II listed and there is a temporary ramp to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.
The dental team includes three dentists, four dental nurses, one dental nurse/receptionist, one trainee dental nurse, three dental hygienists, and three receptionists. The practice has four treatment rooms.
The practice is owned by a partnership and as a condition of registration must have a person registered with the CQC as the registered manager. Registered managers 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 registered manager at Chagford Dental Practice is one of the partners, who is a dentist.
On the day of inspection, we collected 50 CQC comment cards filled in by patients and spoke with two other patients.
During the inspection we spoke with three dentists, three dental nurses, one dental nurse/receptionist, one trainee dental nurse, one dental hygienist and two receptionists. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday, Tuesday and Thursday 9am – 5pm.
Wednesday 9am – 7pm.
Friday 9am – 4pm.
Our key findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures, but improvements could be made.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider had systems to help them manage risk to patients and staff, but improvements should be made to formally risk assess domiciliary visits.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which reflected current legislation.
- 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.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- The provider had information governance arrangements.
There were areas where the provider could make improvements. They should:
- Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular, by considering the risks associated with effective zoning when cleaning and sterilising instruments in the treatment rooms and detergent filled water temperature recording when hand cleaning dental instruments.
- Implement protocols for domiciliary visits taking into account the 2009 guidelines published by British Society for Disability and Oral Health in the document “Guidelines for the Delivery of a Domiciliary Oral Healthcare Service.