The Care Quality Commission
  • Dentist
  • Dentist

Archived: Kyrle Street Dental Practice

18 Kyrle Street, Hereford, Herefordshire, HR1 2ES (01432) 273037

Provided and run by:
Kyrle Street Dental Practice

Important: The partners registered to provide this service have changed. See new profile

All Inspections

2 November 2016

During a routine inspection

We carried out an announced comprehensive inspection on 2 November 2016 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

Kyrle Street Dental Practice is situated close to Hereford city centre. It provides mainly NHS dental treatment for all age groups and a small amount of private dental treatment. There has been a dental practice at the premises for over 40 years. The practice has been operated by the current partnership of two dentists for over 20 years.

In January 2016 the Department of Health (DH) announced the launch of a prototype process as the next stage in the reform of NHS dentistry. Kyrle Street Dental Practice is one of 82 practices in England selected to take part in the Dental Prototype Agreement Scheme. They are testing new ways of providing NHS dental care with an increased emphasis on preventing future dental disease.

One of the two partners 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.

The practice has seven dentists (including the two partners), a dental hygienist, nine dental nurses and three trainee dental nurses. The registered manager and clinical team are supported by a practice manager, two reception staff and an accounts administrator.

The practice has six dental treatment rooms and a separate decontamination room for the cleaning, sterilising and packing of dental instruments. The waiting room is separate from the reception area which helps provide privacy when staff are dealing with patients at the reception desk or on the telephone. Areas of the practice used by patients are all on the ground floor with level access into and around the building. The nearby public car park has designated spaces for patients with disabilities and the practice has space for patients with disabilities to park immediately in front of the building. There is sufficient space within the building for patients who use wheelchairs including in the patient toilet. The practice provides a wheelchair to support patients if required during their visit?

The practice is open from 8.30am to 5pm Monday to Friday and closes for lunch from 1pm to 2pm.

Before the inspection we sent Care Quality Commission comment cards to the practice so patients could give us their views about Kyrle Street Dental Practice. We collected 23 completed cards. Two patients contacted us direct by email. Patients spoke highly of the service they received and described the practice team as professional, efficient, caring and respectful. Patients who commented on being involved in planning their treatment said their treatment met their needs and that their dentist listened to them. Those who commented on cleanliness confirmed that the practice was clean and tidy. The results of the practice’s NHS Friends and Family Test forms for 2016 to date were positive and showed that 91% of the patients who took part were extremely likely or likely to recommend the practice. Only three of the 66 patients who responded said they would not recommend the practice.

Our key findings were:

  • The practice was visibly clean and feedback from patients confirmed this was their experience. National guidance for cleaning, sterilising and storing dental instruments was followed.

  • The practice had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.
  • The practice had arrangements for dealing with medical emergencies.

  • Dental care records provided clear information about patients’ care and treatment and patients received written treatment plans where necessary.
  • Staff received training appropriate to their roles and were supported to meet the General Dental Council’s continuous professional development requirements.
  • Patients were able to make routine and emergency appointments when needed and were gave us positive feedback about the service they received.
  • The practice used the NHS Friends and Family Test, to enable patients to give their views about the practice. Staff had opportunities to contribute their views through daily discussions, staff meetings and annual appraisals.
  • The practice had policies and procedures to help them manage the service. Some record keeping needed consolidation to make information easier to access for monitoring and management purposes.
  • Recruitment arrangements did not ensure that all the required information was always obtained for staff employed. The practice established a new recruitment policy and process immediately.
  • The practice used audit as a means to monitor quality in a range of areas and used repeat audits to ensure improvements had taken place.

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

  • Review the availability of a policy regarding the Duty of Candour to support the practice in providing appropriate information to patients directly affected by adverse incidents.
  • Review the availability of information about translation services for patients who do not speak English as their first language or who use British Sign Language.
  • Review the recording arrangements for some aspects of practice management including incoming safety alert information, fire safety arrangements and staff records.

24 January 2012

During a routine inspection

We spoke by telephone to seven people who attend Kyrle Street Dental Practice. They were all positive about the service they receive. Some had been going to the practice for a long time and told us this was a measure of how good they found it.

People told us that the practice is friendly, flexible and good about fitting them in at short notice if they have a problem. One person said that it had to be good because 'I'm a bit of a fusspot'. People said that they do not usually have to wait long before being called though from the waiting room. People said they rarely wait longer than five or ten minutes.

We asked people whether their dentist gives them clear information about the dental care and treatment they need and any costs involved in this. Everyone we spoke to said that they were. One person commented 'Oh yes, they are very up front'.

We also spoke with people about how the team at the practice dealt with them as people and whether their privacy and dignity was respected. Again, people gave us positive views and made comments such as 'very respectful, very much so, we couldn't be more happy with them' and, 'they put me at ease, I have every faith in their professionalism and standards'.

Several people made a point of commenting that the team was polite and friendly and one person said they appreciated that the staff knew them by name. One person told us they considered they were treated 'superbly' and that the practice was 'a relaxed place to be'. They added that they have noticed other people being dealt with politely too. Several people said they thought it was a professional practice and would happily recommend it; some had done so already.

We spoke with a parent whose children were also patients at Kyrle Street and they gave us a positive picture of the whole family's experiences of the practice. In particular they commented on the careful approach by their dentists which had helped make sure the children had no fear of dentists.

During our visit we heard two people compliment the practice manager on the service they had received. One praised the thoroughness of their dentist and another said they thought the dentists and nurses were all wonderful.

People confirmed that the dentists and nurses wash their hands and always wear protective clothing such as disposable aprons and gloves. They said that they are always given protective goggles to wear during their treatment. People described the general cleanliness and hygiene arrangements at the practice as being 'excellent'. One person commented that there was 'a very high standard of hygiene throughout' and another said that they always see the dental nurses cleaning the equipment.

All the people we spoke with said that they would feel able to raise any concerns if they needed to but that this had never arisen. The only negative comment made to us was that the waiting room could be improved by the addition of seating more suited to people who may not find it so easy to get up and down. Another person had a different view and said they thought the waiting room was the most pleasant they had been in.

We found that the staff team were professional and enthusiastic about dental care and providing people with evidence based treatment which met their needs. We identified that the partners make checks on the quality of the service and ensured that staff have regular training. If the records kept to support this were more structured this could provide more effective and robust management information.