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The Square Advanced Dental Care

Inspection Summary


Overall summary & rating

Updated 24 March 2016

We carried out an announced comprehensive inspection on 9 February 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

The Square Advanced Dental Care is located in the centre of Hale Barns and comprises a reception and waiting room, two treatment rooms, a decontamination room, an office and storage and staff rooms. All rooms are situated on the first floor, accessible by stairs or a lift. Parking is available to the rear of the practice.

The practice provides general dental treatment and a range of more complex treatments, for example, implants and orthodontic treatment, to private patients. It also operates as a referral practice, accepting patients referred from other dental practices for specialist treatment on a private basis.

The practice is open

Monday 9.00am to 5.30pm

Tuesday 8.30am to 7.30pm

Wednesday 9.30am to 8.00pm

Thursday 9.00am to 5.30pm

Friday 8.45am to 5.30pm

Saturday by appointment

The practice is closed for lunch between 1.00pm and 2.00pm.

The practice is staffed by seven dentists, a practice manager, four dental nurses, one of whom is the senior nurse, and another, the treatment co-ordinator, a dental therapist and a receptionist. There are two visiting dentists who provide ad hoc sessions as required.

One of the directors 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.

Nine people provided feedback about the services provided. Feedback reflected very positive comments about the staff and the service. Patients commented that the practice was clean and hygienic, and they found the staff friendly, considerate and caring. They had trust in the staff and confidence in the dental treatments, and said explanations were clear, detailed and understandable.

Several of the dentists deliver the MSc course in Restorative Dentistry under their separate training company in conjunction with The University of Chester, and are involved in teaching on this course.

Our key findings were:

  • The practice recorded and analysed significant events, incidents and complaints and cascaded learning to staff.
  • Staff had received safeguarding training and knew the processes to follow to raise any concerns.
  • There were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Staff had been trained to deal with medical emergencies and emergency medicines and equipment were readily available.
  • Premises and equipment were clean, secure and properly maintained.
  • Infection control procedures were in place and the practice followed published guidance.
  • Staff were supported to deliver effective care, and opportunities for training and learning were available.
  • Clinical staff were up to date with their continuing professional development and met the requirements of their professional registration.
  • Patient’s care and treatment was planned and delivered in line with evidence-based guidelines, and current practice and legislation.
  • Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
  • Patients were treated with dignity and respect and confidentiality was maintained.
  • The appointment system met the needs of patients and delays were kept to a minimum.
  • The practice staff felt involved and worked as a team.
  • The practice sought feedback from staff and patients about the services they provided.
  • Governance arrangements were in place for the smooth running of the practice and the practice had a structured plan in place to audit quality and safety.

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

  • Review the frequency of checks on medical emergency equipment in line with Resuscitation Council UK guidelines, and review procedures for stock control of medicines.
  • Review the storage of cleaning equipment.
  • Devise a method of checking and recording that visiting dental professionals have completed continuing professional development training in core subjects.

Inspection areas

Safe

No action required

Updated 24 March 2016

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

There were systems in place for identifying, investigating and learning from incidents relating to patient safety.

Staff understood their responsibilities for identifying and reporting potential abuse. Staff were trained in safeguarding and there were policies and procedures in place for staff to follow.

The practice had a recruitment policy and recruitment procedures in place which were in accordance with current regulations.

Several of the dentists in the practice were specialists in their fields, some in several fields, and held hospital consultant, and academic and teaching posts, in addition to providing dental treatment at the practice.

Risks had been identified and assessed and staff were aware of how to minimise risks.

We found the equipment used in the practice, including medical emergency and radiography equipment, was well maintained and tested at regular intervals.

There were arrangements in place for managing medicines, including emergency medicines, to ensure they were stored safely.

There were systems in place to reduce and minimise the risk and spread of infection and the premises and equipment were clean, secure and properly maintained. However the cleaning cupboard was cluttered and mops were inappropriately stored.

Effective

No action required

Updated 24 March 2016

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

The practice provided evidence-based care in accordance with relevant published guidance. The practice monitored patients’ oral health and gave appropriate health promotion advice tailored to the patient’s individual needs. Dentists explained treatment options and costs to patients to assist them in making an informed decision before treatment was carried out. Patients reported that information provided was excellent. Consent was obtained before treatment was commenced.

The practice accepted referrals internally from colleagues and from other dental practices. When required dentists referred patients to other services for care in a timely manner.

Staff were registered with the General Dental Council and engaged in continuing professional development, (CPD), to meet the requirements of their registration. Staff were supported through training, appraisals, and opportunities for development. Training and the skill mix of staff were core to provision of the service.

Caring

No action required

Updated 24 March 2016

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

Patients commented that the staff were caring, polite, and friendly. They told us that they were treated with dignity and respect and their privacy was maintained. Patient information was handled confidentially. Reception staff anticipated patient’s individual needs and accommodated them.

We saw that treatment was clearly explained and patients were provided with written treatment plans. Patients commented they felt they were treated with great skill.

Patients with urgent dental needs or in pain were responded to promptly and were usually seen by a dentist on the same day.

Responsive

No action required

Updated 24 March 2016

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

Patients had access to appointments to suit their preferences, and emergency appointments were available on the same day.

The practice was accessible to people with disabilities, impaired mobility, and to wheelchair users by means of a lift. Treatment rooms were accessible and there was an accessible toilet.

Access to interpretation services was available. The practice leaflet included information about access.

The practice used the skill mix, experience and knowledge of the staff to improve outcomes for their patients.

Information about emergency treatment and out of hours care was displayed at the practice entrance, on the answerphone and contained in the practice leaflet.

The practice had a complaints policy which was displayed in the waiting room, on the practice website and outlined in the practice leaflet.

Well-led

No action required

Updated 24 March 2016

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

The practice had a clear leadership structure in place and shared roles and responsibilities amongst staff. The practice had robust governance arrangements in place and clear policies and procedures which were being followed by staff.

Staff were supported to maintain their professional development and skills. The practice staff met regularly to review all aspects of the delivery of dental care and the management of the practice.

Auditing processes and learning from complaints were used to monitor and improve performance.

Patients and staff were able to feedback compliments and concerns regarding the service and the practice acted on them. Patients commented that the practice took notice of their concerns.