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Bridge House Dental Practice

Inspection Summary


Overall summary & rating

Updated 17 December 2019

We carried out this announced inspection on 25 October 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 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 not providing well-led care in accordance with the relevant regulations.

Background

Bridge House Dental Practice is in Market Deeping, a market town in the South Kesteven district of Lincolnshire. It provides NHS and private dental treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs through an alternative entrance at the side of the practice. Car parking spaces are available at the rear of the premises in their own car park.

The dental team includes two dentists, one dental hygienist, three dental nurses; one of the dental nurses also undertakes the role of practice manager.

The practice has three treatment rooms; two are on ground floor level.

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 Bridge House Dental Practice is the principal dentist.

We sent 50 comment cards in advance of our visit to the practice for patients to complete. On the day of inspection, we collected six CQC comment cards that had been filled in by patients. This represented a 12% response rate.

During the inspection we spoke with one dentist, two dental nurses (including the practice manager). We looked at practice policies and procedures, patient feedback and other records about how the service is managed.

The practice is open: Monday, Wednesday and Thursday from 8.15am to 5.15pm, Tuesday 8.15am to 6pm, Friday 8am to 4pm. The practice also opened on two Saturdays a month by appointment only.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The provider had infection control procedures which mostly reflected published guidance. We noted there was scope for improvement when manual cleaning was undertaken.
  • Staff knew how to deal with emergencies. Most appropriate medicines and life-saving equipment were available with exception of glucagon. This is used to treat severe low blood sugar in the event of a dental emergency. This was ordered promptly after our inspection.
  • The provider had insufficient systems to help them manage all risks to patients and staff.
  • The provider had safeguarding processes, although some of this required review. Staff were trained to know their responsibilities for safeguarding vulnerable adults and children.
  • The provider did not have adequate 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.
  • Staff provided preventive care and supported patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • The provider did not demonstrate effective leadership and culture of continuous improvement.
  • The provider had not asked staff and patients for any detailed feedback about the services they provided.
  • The provider had systems to deal with complaints positively and efficiently.
  • It was not clear that learning always took place when things went wrong.

We identified regulations the provider was not complying with. They must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation/s the provider was not meeting are at the end of this report.

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

  • Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
  • Review the necessity of a second oxygen cylinder where appropriate for the practice's circumstances.
  • Improve and develop staff awareness of Gillick competency and consent and ensure all staff are aware of their responsibilities in relation to this.
  • Implement processes and systems for seeking and learning from staff feedback with a view to monitoring and improving the quality of the service.
Inspection areas

Safe

No action required

Updated 17 December 2019


Effective

No action required

Updated 17 December 2019


Caring

No action required

Updated 17 December 2019


Responsive

No action required

Updated 17 December 2019


Well-led

Improvements required

Updated 17 December 2019