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Inspection Summary


Overall summary & rating

Updated 19 December 2018

We carried out this announced inspection on 31 October 2018 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 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

LG Woodgate Limited dental practice is in the centre of Newton and provides NHS and private dental care for adults and children.

There is level access to facilitate entrance to the practice for people who use wheelchairs and for pushchairs. Car parking is available near the practice.

The dental team includes a principal dentist, four associate dentists and eight dental nurses, two of whom are trainees. The practice has five treatment rooms.

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 LG Woodgate Limited was the principal dentist.

We received feedback from 12 people during the inspection about the services provided. The feedback provided was positive.

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

The practice is open:

Monday, Tuesday, Wednesday 8.30am to 5.30pm

Thursday 8.30am to 6.00pm

Friday 8.30am to 5.00pm

Our key findings were:

  • The practice was clean and well maintained.
  • The practice had infection control procedures in place which reflected published guidance.
  • The provider had safeguarding procedures in place and staff knew their responsibilities for safeguarding adults and children.
  • Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available.
  • The provider had staff recruitment procedures in place.
  • Staff provided patients’ care and treatment in line with current guidelines.
  • The dental team provided preventive care and supported patients to achieve better oral health.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system took account of patients’ needs.
  • The provider had a procedure in place for dealing with complaints. The practice dealt with complaints positively and efficiently. Contact details for NHS England were not available for patients should they wish to complain to them directly.
  • The practice had a leadership and management structure.
  • The provider had systems in place to manage risk. Systems relating to vaccination status in staff and the use of sharps were not operating effectively.
  • Staff felt involved and supported and worked well as a team.
  • The practice asked patients and staff for feedback about the services they provided.

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

  • Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, in relation to the use of sharps, and the effectiveness of the Hepatitis B vaccination in staff.
Inspection areas

Safe

No action required

Updated 19 December 2018

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

The provider had systems and processes in place to provide safe care and treatment. The practice used learning from incidents to help them improve.

Staff received training in safeguarding and knew how to report concerns.

Staff were qualified for their roles, where relevant.

The premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The provider completed essential recruitment checks before employing staff. The provider had not carried out a Disclosure and Barring Service check on one recently recruited member of staff prior to employment, and no risk assessment of this was in place. This check was in progress.

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

The practice had systems in place for the safe use of X-rays. Some amendments could be made to the local rules and working instructions.

The provider had a system in place for checking the effectiveness of the Hepatitis B vaccination in staff. No checks had been carried out for three staff and no risk assessments were in place. After the inspection the provider sent us evidence that risk assessments had been carried out immediately following the inspection.

Effective

No action required

Updated 19 December 2018

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 first class. The dentists discussed treatment with patients so they could give informed consent and recorded this in their records.

The practice participated in national and local oral and general health campaigns to support patients to live healthier lives and directed patients to sources of help and advice.

The practice had clear arrangements for referring patients to other dental or health care professionals.

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

Caring

No action required

Updated 19 December 2018

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

We received feedback about the practice from 12 people. Patients were positive about all aspects of the service the practice provided. They told us staff were caring, friendly and knowledgeable.

Patients said they were given options for treatment and full explanations of 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.

Staff protected patients’ privacy and were aware of the importance of confidentiality.

Patients said staff treated them with dignity and respect and went out of their way to care for their individual needs.

Responsive

No action required

Updated 19 December 2018

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 book an appointment quickly if in pain.

Staff considered patients’ differing needs and put measures in place to help all patients receive care and treatment. This included providing facilities for patients with disabilities and families with children.

The practice had access to interpreter services and had arrangements to assist patients who had sight or hearing loss.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively. Contact details for NHS England were not available for patients should they wish to complain to them directly. The provider sent us evidence after the inspection that these details had now been made available.

Well-led

No action required

Updated 19 December 2018

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

The provider had arrangements in place to ensure the smooth running of the service. These included systems for the practice team to monitor the quality and safety of the care and treatment provided.

There was a clearly defined management structure and staff felt supported and appreciated.

The provider had the capacity and skills to deliver high-quality, sustainable care. They were knowledgeable about issues and priorities relating to the quality and future of the service. The practice planned its services to meet the needs of the practice population.

The practice had procedures in place to manage and reduce risks. Systems relating to vaccination status in staff and the use of sharps were not operating effectively. After the inspection the provider sent us evidence to demonstrate that improvements had been made to these systems.

The practice team kept accurate, complete patient dental care records which were stored securely.

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