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Inspection Summary


Overall summary & rating

Updated 4 February 2016

We carried out an announced comprehensive inspection on 12 January 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 practice offers private primary care dentistry to adult patients and children are treated under the NHS.

The practice is open Monday, Tuesday and Thursday from 8.45am to 5.30pm. On a Wednesday the practice is open from 9am to 8.00pm. The practice closes at 5pm on a Friday.

There are two dentists, four dental nurses, one trainee dental nurse, three dental hygienist/ therapists, two receptionists and a business manager supported by a practice coordinator.

The principal dentist is the registered person for the practice. 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 received feedback from patients about the service via seven Care Quality Commission (CQC) comment cards. All the comments were positive about the staff and the services provided. Comments included: staff are helpful, understanding and provide a great service.

Our key findings were:

  • There was an effective complaints system.
  • Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it.
  • There were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Staff had been trained to manage medical emergencies.
  • Infection control procedures were in accordance with the published guidelines.
  • Patient care and treatment was planned and delivered in line with evidence based guidelines and current regulations.
  • 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.
  • Patients could access routine treatment and urgent care when required.
  • The practice was well-led, staff felt involved and supported and worked well as a team.
  • The governance systems were effective.
  • The practice sought feedback from staff and patients about the services they provided.
Inspection areas

Safe

No action required

Updated 4 February 2016

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

The practice had effective systems and processes in place to ensure that all care and treatment was carried out safely. For example, there were systems in place for infection control, clinical waste control, management of medical emergencies and dental radiography.

There was a nominated person in respect of Duty of Candour. The Duty of Candour is a legal duty on health providers to inform and apologise to patients if there have been mistakes in their care that have led to significant harm. Duty of Candour aims to help patients receive accurate, truthful information from health providers.

Staff had received training in safeguarding patients and knew how to recognise the signs of abuse and how to report them. Staff had also received training in infection control. There was a decontamination room and guidance for staff on effective decontamination of dental instruments.

Staff were appropriately recruited and suitably trained and skilled to meet patients’ needs and there were sufficient numbers of staff available at all times. Staff induction processes were in place and had been completed by new staff.

We reviewed the legionella risk assessment and no concerns were identified.

Effective

No action required

Updated 4 February 2016

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

Consultations were carried out in line with good practice guidance from the National Institute for Health and Care Excellence (NICE). For example, patients where recalled after an agreed interval for an oral health review, during which their medical histories and examinations were updated and any changes in risk factors noted.

On joining the practice, patients underwent an assessment of their oral health and were asked to provide a medical history. This information was used to plan patient care and treatment. Patients were offered options of treatments available and were advised of the associated risks and benefits. Patients were provided with a written treatment plan which detailed the treatments considered and agreed together with the fees involved.

Patients were referred to other specialist services where appropriate in a timely manner.

Staff were registered with the General Dental Council (GDC) and maintained their registration by completing the required number of hours of continuing professional development (CPD) activities.

We found that there were robust governance systems in place to underpin the provision of conscious sedation. The systems and processes we observed were in accordance with the new guidelines recently published by the Royal College of Surgeons and Royal College of Anaesthetists in April 2015.

Caring

No action required

Updated 4 February 2016

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

The practice had procedures in place for respecting patients’ privacy, dignity and providing compassionate care and treatment. If a patient needed to speak to a receptionist confidentially they would speak to them in the treatment room or in another private room.

Comments on the seven completed CQC comment cards we received included statements saying the staff were helpful and understanding, great service and pleasant staff and all staff were excellent.

Responsive

No action required

Updated 4 February 2016

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

Patients could access routine treatment and urgent care when required. The practice offered daily access for patients experiencing dental pain which enabled them to receive treatment quickly.

The practice had a complaints process which was available to support any patients who wished to make a complaint. The process described the timescales involved for responding to a complaint and who was responsible in the practice for managing them.

Well-led

No action required

Updated 4 February 2016

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

Staff were supported through training and offered opportunities for development.

Staff reported that the registered provider was approachable and they felt supported in their roles and were freely able to raise any issues or concerns with them at any time. The culture within the practice was seen by staff as open and transparent. Staff told us that they enjoyed working there.

The practice regularly sought feedback from patients in order to improve the quality of the service provided.

The practice undertook various audits to monitor its performance and help improve the services offered. The audits included infection control, X-rays, clinical examinations and patients’ records.

The practice held regular staff meetings which were minuted and gave everybody an opportunity to openly share information and discuss any concerns or issues which had not already been addressed during their daily interactions.