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Inspection Summary


Overall summary & rating

Updated 27 December 2018

We carried out this announced inspection on 6 December 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 registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a Care Quality Commission 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

The Bush Dental Clinic is in Shepherds Bush is in the London Borough of Hammersmith. The practice provides NHS and private treatment to patients of all ages. There is level access for people who use wheelchairs and those with pushchairs.

The practice is situated close to public transport bus and train services.

The dental team includes the two principal dentists who own the practice, five associate dentists including a periodontist and an endodontist, one dental hygienist, five dental nurses and one trainee dental nurse. The clinical team are supported by a practice manager and three receptionists.

The practice is owned by a partnership 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 The Bush Dental Clinic was one of the principal dentists.

On the day of inspection we received feedback from 48 patients.

During the inspection we spoke with the principal dentists, two associate dentists, one dental nurse, and the practice manager.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Mondays between 9am and 5pm.

Tuesdays between 9am and 5.30pm.

Wednesdays and Thursdays between 8.30am and 5.30pm.

Fridays between 8.30 am and 1.30 pm.

24 hour telephone advice is provided by one of the principal dentists.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The practice had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies.
  • The practice had systems to help them manage risk.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had thorough staff recruitment procedures.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The practice was providing preventive care and supporting patients to ensure better oral health.
  • The appointment system met patients’ needs.
  • The practice had effective leadership.
  • Staff felt involved and supported and worked well as a team.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice dealt with complaints positively and efficiently.
  • The practice had suitable information governance arrangements.
Inspection areas

Safe

No action required

Updated 27 December 2018

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.

There were systems to use learning from incidents and complaints to help them improve. This included receiving and responding to patient safety alerts.

Staff received training in safeguarding 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.

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

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

Effective

No action required

Updated 27 December 2018

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

The dentist assessed patients’ needs and provided care and treatment in line with recognised guidance.

Patients described the treatment they received as exemplary, excellent and to a very high standard.

The dentists discussed treatment with patients so they could give informed consent and recorded this in their records. Patients told us that their dentist and the dental hygienist always explained their treatment in detail.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals. There were protocols to ensure that routine and urgent referrals were monitored suitably.

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

Caring

No action required

Updated 27 December 2018

We found that this practice was providing caring services in accordance with

the relevant regulations.

We received feedback about the practice from 48 people. Patients were positive about all aspects of the service the practice provided. They told us that the dental staff were respectful, caring and kind and the receptionists were exceptional and helpful.

Patients said that the dentists and dental hygienist listened to them and helped them to understand the treatment provided including any options available.

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

Responsive

No action required

Updated 27 December 2018

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

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain. Patients commented that they received treatment in a timely manner and that they could make appointments easily.

Staff considered and took into account patients’ different needs. The layout and design of the practice provided level access and each of the six treatment rooms were located on the ground floor.

The practice had arrangements to help patients whose first language was not English and those with sight or hearing loss should these be required.

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

Well-led

No action required

Updated 27 December 2018

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 patient dental care records which were clearly written or typed and stored securely.

The practice had a range of policies and procedures to underpin the day to day management of the service. These were bespoke and reflected the day to day running if the practice, were kept under review and were accessible to the practice team.

The practice 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.