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Inspection Summary


Overall summary & rating

Updated 30 March 2017

We carried out an announced comprehensive inspection on 07 February 2017 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

Berwick Smile Dental Care was initiated in 2010 and provides private treatment to patients of all ages. The purpose-built practice consists of two treatment rooms, two consultation rooms, a dedicated decontamination room for sterilising dental instruments, a reception with waiting area, a staff room and general office. Car parking is available in front of the practice. Access for wheelchair users or pushchairs is possible via the ground-floor entrance.

The practice is open Monday – Thursday 0900 -1700 and Friday 0900 -1300 with extended opening hours to 1900 once a week on alternate Mondays and Wednesdays.

The dental team is comprised of the principal dentist (who is also the registered provider), an associate dentist, a dental hygienist and five dental nurses (one of whom is a trainee). The senior dental nurse is also a treatment co-ordinator and all dental nurses undertake administration and reception duties.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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 offers general and specialised dental treatments including dental implants and simple orthodontics.

We reviewed 15 CQC comment cards on the day of our visit; patients were very positive about the staff and standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

  • Staff were very friendly, caring and enthusiastic.
  • The practice was visibly clean and an Infection prevention and control policy was in place.
  • We saw sterilisation procedures followed recommended guidance.
  • The practice had systems for recording incidents and accidents.
  • Dental professionals provided treatment in accordance with current professional guidelines.
  • Patient feedback was regularly sought and reflected upon.
  • Patients could access urgent care when required.
  • Dental professionals were maintaining their continued professional development (CPD) in accordance with their professional registration.
  • Complaints were dealt with in an efficient and positive manner.
  • Staff received annual medical emergency training.
  • Equipment for dealing with medical emergencies mostly reflected guidance from the resuscitation council.
  • Staff were aware on how to escalate safeguarding issues for children and adults should the need arise. Contact details were available within their safeguarding policy.
  • Staff were involved in charity work, providing oral health education and dental treatment abroad.

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

  • Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance
  • Review the responsibilities with regards to the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and ensure all documentation is up to date.
  • Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
  • Review the system for training, assessment and supervision of all staff.
  • Review the system for identifying and disposing of out-of-date medicines and equipment.
  • Review the storage of medicines requiring refrigeration to ensure the fridge temperature is monitored and recorded.
Inspection areas

Safe

No action required

Updated 30 March 2017

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

Infection prevention and control procedures followed recommended guidance.

Equipment for decontamination procedures, radiography and general dental procedures were tested and checked according to manufacturer’s instructions.

Emergency medicines and equipment were not fully in accordance with guidelines; we found two items had expired and two items were missing.

The practice had processes for recording and reporting any accidents and incidents. The practice did not give full regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 with respect to their sharps procedures.

The practice’s Control of Substances Hazardous to Health (COSHH) file did not contain risk assessments for all the materials held within the practice. The practice had not implemented the required actions from their legionella risk assessment.  

Effective

No action required

Updated 30 March 2017

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

Dental professionals referred to resources such as the National Institute for Health and Care Excellence (NICE) guidelines and the Delivering Better Oral Health toolkit (DBOH) to ensure their treatment followed current recommendations.

Staff obtained consent and made referrals to other services in an appropriate and recognised manner.

Staff who were registered with the General Dental Council (GDC) met the requirements of their professional registration by carrying out regular training and continuing professional development (CPD).

Caring

No action required

Updated 30 March 2017

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

Patients were very positive about the staff, practice and treatment received. We left CQC comment cards for patients to complete two weeks prior to the inspection. There were 15 responses all of which were very positive, with patients stating they felt listened to and received the best treatment at that practice.

We observed patients being treated with respect and dignity during our inspection and privacy and confidentiality were maintained for patients using the service. We also observed staff to be welcoming and caring towards patients.

The waiting area was equipped with dental advice and practice information leaflets, tea and coffee facilities and a child play area.

Dental care records were kept securely and computers were password protected.

Responsive

No action required

Updated 30 March 2017

We found that this practice was providing responsive care in accordance with

the relevant regulations.

The practice had dedicated slots each day for urgent dental care and every effort was made to see all emergency patients on the day they contacted the practice.

The practice had considered the needs of various population groups and could accommodate wheelchair users/pushchairs within their ground floor surgeries and patient toilet.

Privacy and confidentiality were maintained for patients at all times.

Well-led

No action required

Updated 30 March 2017

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

The principal dentist was on-site every day of the week. There were dedicated leads in infection prevention and control and safeguarding as well as various policies for staff to refer to.

The principal dentist kept all staff files, training logs and certificates on the premises; we found training logs were not completed for all staff.

There were regular quality checks of clinical and administration work; the practice undertook a range of audits and risk assessments.

Staff were encouraged to provide feedback on a regular basis through staff meetings and informal discussions.

Patient feedback was also encouraged verbally and online. The results of any feedback were discussed in meetings for staff learning and improvement.