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St Michael's Dental Practice

Inspection Summary


Overall summary & rating

Updated 14 March 2019

We carried out this announced inspection on 12 February 2019 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 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 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

St Michael’s Dental Practice is in South Shields and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. The practice has three treatment rooms, all on the first floor. A stairlift is available for those who require help with ascending the stairs. Car parking spaces are available near the practice.

The dental team includes three dentists (one of whom is the principal dentist), six dental nurses (one of whom is a trainee), a practice manager and a receptionist.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 St Michael’s Dental Practice is the principal dentist.

On the day of inspection, we collected 49 CQC comment cards filled in by patients. These provided a positive view of the practice.

During the inspection we spoke with three dentists, four dental nurses, the receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 9am to 5.30pm

Tuesday and Wednesday 9am to 6pm

Thursday and Friday 9am to 5pm

Saturday 9am to 12pm by appointment only

Our key findings were:

  • The practice appeared clean and well maintained.
  • The provider had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. The practice should review the storage of their medical drugs and equipment.
  • The practice had systems to help them manage risk to patients and staff. They should review their Legionella risk assessment to ensure all actions are completed.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had thorough staff recruitment procedures. They should review their protocols for undertaking Disclosure and Barring Service (DBS) checks, or a risk assessment to mitigate the risk of not doing this, prior to employment.
  • The clinical staff provided patients’ care and treatment in line with current guidelines. The practice should review their protocols for carrying out treatment in a domiciliary setting to ensure it reflects national guidance.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • Staff were providing preventive care and supporting patients to ensure better oral health. Staff attended local organisations to provide oral health education and the principal dentist was one of the founding members of a dental health charity in Nepal.
  • The appointment system took account of patients’ needs.
  • The provider had effective leadership and culture of continuous improvement.
  • Staff felt involved and supported and worked well 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 suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

  • Review the practice's protocols for medicines management and ensure all medical emergency drugs and equipment are stored safely and securely.
  • Review the practice's Legionella risk assessment and implement any recommended actions, 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.’
  • Review the practice's recruitment procedures to ensure that appropriate DBS checks are completed prior to staff commencing employment at the practice.
  • Review the practice’s 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”.

Inspection areas

Safe

No action required

Updated 14 March 2019

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

The practice had systems and processes to provide safe care and treatment. They used learning from incidents and complaints to help them improve.

Staff received training in safeguarding people and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed essential recruitment checks.

The provider had thorough staff recruitment procedures. They undertook DBS checks for all staff, except one where they had used the DBS check from their previous employer, prior to employment.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments. The provider should review their Legionella risk assessment to ensure all actions are completed or discuss with their Legionella risk assessor for clarity.

The practice had suitable arrangements for dealing with medical and other emergencies.

The practice staff should review the storage of their medical drugs and equipment.

Effective

No action required

Updated 14 March 2019

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

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as of a high and professional standard. The dentists discussed treatment with patients so they could give informed consent and recorded this in their records. The practice should review their protocols for carrying out treatment in a domiciliary setting to ensure it reflects national guidance.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

The provider supported staff to complete training relevant to their roles and had systems to help them monitor this.

The staff were involved in quality improvement initiatives such as peer review as part of its approach in providing high quality care.

The practice was involved in delivering oral health education to local organisations and in dental charity work abroad.

Caring

No action required

Updated 14 March 2019

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

We received feedback about the practice from 49 people. Patients were positive about all aspects of the service the practice provided. They told us staff were kind, caring and considerate to their needs. They said that they were given helpful, honest explanations about dental treatment, and said their dentist listened to them. Patients commented that staff made them feel at ease, especially when they were anxious about visiting the dentist.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 14 March 2019

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

The practice’s appointment system took account of patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. This included providing facilities for patients with a disability and families with children. The practice had access to interpreter services and had arrangements to help patients with sight or hearing loss.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 14 March 2019

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

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided. There was a clearly defined management structure and staff felt supported and appreciated.

The practice team kept complete patient dental care records which were, clearly written or typed and stored securely.

The provider monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.