Rugby Dental Care

We carried out this announced inspection on 18 November 2019 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Rugby Dental Care is located near Rugby town centre and provides NHS and private dental care and treatment for adults and children.

There are two small steps at the practice entrance. Staff told us they are able to accommodate people who use wheelchairs and those with pushchairs by assisting them with these steps. Car parking spaces are available near the practice but there are no dedicated spaces for blue badge holders.

The dental team includes five dentists and five dental nurses (one of whom is a trainee dental nurse). One of the dentists holds a specialism in oral surgery. The dental nurses also carry out reception duties. The practice has three treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 27 CQC comment cards filled in by patients.

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

The practice is open from Monday to Friday between 8:45am and 5:15pm and closed for lunch between 12:30pm and 1:30pm.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which mostly reflected published guidance. Improvements were made to strengthen processes within 48 hours of our inspection.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available with the exception of a few items. These were promptly ordered.
• The provider had systems to help them manage risk to patients and staff although improvements were required. Improvements were made to strengthen processes within 48 hours of our inspection.

• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. All staff had completed training. One staff member had not completed training to the recommended level but completed this immediately once we brought this to their attention.
• The provider had staff recruitment procedures which reflected current legislation. Improvements were needed to ensure complete immunisation records were available for all clinical staff members.

• 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.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements.

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

• Take action to implement any recommendations in the practice's Legionella risk assessment, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular, the disinfection of waterlines.
• Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• Take action to ensure audits of infection prevention and control are undertaken at regular intervals to improve the quality of the service. Staff should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
• Improve the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities.