We carried out an announced comprehensive inspection on 13 October 2015 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 not providing well-led care in accordance with the relevant regulations; however the provider took action shortly after our inspection to address concerns.
Background
Claremont Dental Practice is located in Twickenham in the London Borough of Richmond upon Thames. The practice provides NHS and private dental services for both adults and children. It offers a range of dental services including routine examinations and treatment, restorative treatment, oral surgery, periodontal treatment, oral health promotion and hygiene, orthodontic treatment and cosmetic procedures such as tooth whitening.
The practice is arranged over the ground, first and second floors and has five treatment rooms, two of which are on the ground floor. The practice also has a dedicated decontamination room, a room for radiography, and a reception area with a toilet for patients.
The practice is staffed by three partner dentists, an associate dentist, four part-time specialist dentists, two dental hygienists, seven dental nurses and a trainee dental nurse. The practice employs a practice manager, and a receptionist.
A partner dentist and practice manager are the registered managers. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 is open from 8.00am to 7.00pm Monday and Tuesday, 8.00am to 6.00pm Wednesday and Thursday, 8.00am to 4.00pm Fridays, 9.00am to 1.00pm Saturday and 9.00am to 4.00pm alternate Saturdays.
We carried out an announced, comprehensive inspection on 13 October 2015. The inspection took place over one day and was carried out by a CQC inspector and a dentist specialist advisor.
We reviewed 43 CQC patient comment cards and spoke with four patients. Patients we spoke with, and those who completed comment cards, were positive about the care they received from the practice. Patients described the staff as friendly and caring. They told us they felt involved in decisions about their care and were treated with dignity and respect.
Our key findings were:
- Patients’ needs were assessed and care was planned in line with best practice guidance, such as from the National Institute for Health and Care Excellence (NICE).
- Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, oxygen cylinder and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
- Patients indicated that they felt they were listened to and that they received good care from a helpful and patient practice team.
- The practice had implemented clear procedures for managing comments, concerns or complaints.
- The partner dentists had a clear vision for the practice and staff told us they were well supported by the dentists and their colleagues.
- Governance arrangements were not always robust. The practice had not undertaken all relevant recruitment checks for new members of staff but they told us this would be implemented in future.
- Staff engaged in Continuous Professional Development (CPD) and most were meeting the training requirements of the General Dental Council (GDC). For some staff members, mandatory training had lapsed and needed to be updated. We were provided with evidence to show that all outstanding training was completed shortly after our inspection.
We identified regulations that were not being met and the provider must:
- Ensure an effective system is established to assess, monitor and mitigate the risks arising from undertaking of the regulated activities.
- Ensure the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.
You can see full details of the regulations not being met at the end of this report.
There were areas where the provider could make improvements and should:
- Review recruitment procedures to ensure accurate, complete and detailed records including appropriate records of references are maintained for all staff.
- Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff.
- Review its audit protocols to ensure audits of various aspects of the service, such as on dental care records are undertaken at regular intervals to help improve the quality of service. Practice should also ensure audits have documented learning points that are shared with relevant staff, and the resulting improvements can be demonstrated.