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Inspection Summary


Overall summary & rating

Updated 21 October 2016

We carried out an announced comprehensive inspection on 26 September 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

Northway dental practice is situated in Maghull. The practice has two dental treatment rooms, a waiting area, a reception area and a patient toilet on the ground floor of the premises. A further two treatment rooms, a dedicated decontamination room; office and storage facilities are situated on the first floor.

There is wheelchair access and disabled toilet facilities on the ground floor. Patients with restricted mobility and families with pushchairs or young children were seen in one of the ground floor treatment rooms.

The Practice offers mainly NHS treatment (approximately 75%) to patients of all ages and some private dental care services. The services provided include preventative advice and treatment and routine and restorative dental care.

The practice has two principal dentists, whom are the owners, an associate dentist, a foundation dentist, a dental hygiene therapist and five qualified dental nurses. A practice manager and lead receptionist, both of whom are qualified dental nurses; and a business manager complete the dental team. The practice is open Monday to Friday from 9.00am until 5.00pm.

The practice is a training practice for the Dental Foundation Training (DFT) scheme. DFT provides postgraduate dental education for newly qualified dentists in their first (foundation) year of practice; usually within general dental practices. One of the principal dentists is a trainer for the DFT scheme and provides clinical and educational supervision. The practice currently has one full time dentist who is in their first (foundation) year of practice.

One of the principal dentists 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.

We viewed 43 CQC comment cards that had been left for patients to complete, prior to our visit, about the services provided. We reviewed patient feedback gathered by the practice over the last 12 months. Feedback from patients was positive about the care they received from the practice. They commented that staff put them at ease and listened to their concerns and that they had confidence in the dental services provided.

Our key findings were:

  • We found the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.

  • The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding, recruitment and the management of medical emergencies.

  • Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.

  • Patients commented they felt involved in their treatment and that it was fully explained to them.
  • Patients were able to make routine or emergency appointments when needed. There were clear instructions for patients regarding out of hours care.
  • There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
  • The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
  • There were systems to monitor and continually improve the quality of the service; including a programme of clinical and non-clinical audits.
  • There were clearly defined leadership roles within the practice and staff told us they felt well supported and comfortable to raise concerns or make suggestions.
  • Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice owners, practice manager and business manager.
Inspection areas

Safe

No action required

Updated 21 October 2016

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

The practice had effective arrangements for essential areas such as infection prevention and control, management of medical emergencies and dental radiography (X-rays). There were systems in place for identifying, investigating and learning from incidents relating to the safety of patients and staff members.

There were clear procedures regarding the maintenance of equipment and the storage of medicines in order to deliver care safely. Medicines for use in the event of a medical emergency were safely stored and checked to ensure they were in date and safe to use. All staff had received training in responding to a medical emergency including cardiopulmonary resuscitation (CPR).

There were sufficient numbers of suitably qualified staff working at the practice. The practice followed procedures for the safe recruitment of staff and had systems in place to support them carry out their work. Staff had received safeguarding training and were aware of their responsibilities regarding safeguarding children and vulnerable adults.

Effective

No action required

Updated 21 October 2016

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

The dental care provided was evidence based and focussed on the needs of the patient. The practice used current national professional guidance including that from the National Institute for Health and Care Excellence (NICE) to guide their practice. Staff were knowledgeable about how to ensure patients had sufficient information and the mental capacity to give informed consent.

Patients’ dental care records provided comprehensive information about their current dental needs and past treatment. The practice monitored any changes in the patient’s oral health and made referrals to specialist services for further investigations or treatment if required.

The practice focused strongly on prevention and the dentists were aware of the ‘Delivering Better Oral Health’ toolkit (DBOH) with regards to fluoride application and oral hygiene advice. Staff were proactive about providing patients with information and in signposting patients to local support services.

Caring

No action required

Updated 21 October 2016

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

We looked at 43 CQC comment cards patients had completed prior to the inspection. Patients were overwhelmingly positive about the care they received from the practice, felt fully involved in making decisions about their treatment and listened to. The practice provided patients with information to enable them to make informed choices about treatment.

Staff we spoke with were aware of the importance of providing patients with privacy and how to maintain confidentiality. Policies and procedures were in place regarding patient confidentiality and maintaining patient data securely.

Responsive

No action required

Updated 21 October 2016

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

The practice offered routine and emergency appointments each day. There were clear instructions for patients requiring urgent care when the practice was closed. The practice supported patients to attend their forthcoming appointment by having a text reminder system in place.

The practice was aware of the needs of the local population and took these into account in how the practice was run. For example, staff were prompted to be aware of patients’ specific needs or medical conditions via the use of a flagging system on the dental care records. The practice had two ground floor treatment rooms with access into the building for patients with restricted mobility and families with prams and pushchairs.

There was an effective system in place for acknowledging, recording, investigating and responding to complaints, concerns and suggestions made by patients. Information for patients about how to raise a concern or offer suggestions was available in the waiting room.

Well-led

No action required

Updated 21 October 2016

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

Leadership was provided by the principal dentists, practice and business managers. Staff told us that they felt well supported and confident to raise concerns and request support.

The practice identified, assessed and managed clinical and environmental risks related to the service provided. There was a comprehensive range of policies and procedures in use at the practice which were easily accessible to staff. A range of meetings; including for the staff as a whole, the dentists and the leadership team, were arranged to share information, provide additional training and give staff an opportunity to raise any concerns.

The practice had a system to monitor and continually improve the quality of the service through a programme of clinical and non-clinical audits. The practice had systems in place to seek and act upon feedback from patients using the service.