Archived: North Road Dental Surgery

We carried out this announced inspection on 3 December 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 not providing well-led care in accordance with the relevant regulations.

Background

North Road Dental Surgery is in Boldon and provides NHS and private dental care and treatment for adults and children.

Access for wheelchair users or people with pushchairs is possible via a portable ramp at the front entrance. Car parking spaces are available near the practice.

The dental team includes two principal dentists, an associate dentist, a dental hygiene therapist, four qualified dental nurses (one of whom is the practice manager) and two trainee dental nurses. Dental nurses carry out reception duties. The practice has three treatment rooms.

The practice is owned by an individual who is one of the principal dentists 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 two CQC comment cards filled in by patients.

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

The practice is open:

Monday and Friday 8.30am to 5pm

Tuesday 9am to 6pm

Wednesday and Thursday 9am to 5pm

Saturday 9am to 12pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment was not available in line with national guidance. Items were ordered the following day.
• The provider had limited systems to help them manage risk to patients and staff. We discussed the need to improve their existing risk management protocols in relation to radiography, medical emergencies, significant events and sepsis awareness.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures which reflected current legislation.
• 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 provider should ensure staff and patient information is not accessible to unauthorised people.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider should review their leadership, to promote 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.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider is not meeting are at the end of this report.

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

• Improve and develop staff awareness of the requirements of the Mental Capacity Act 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Take action to ensure the clinicians take into account the guidance provided by the Faculty of General Dental Practice when carrying out X-rays.
• Take action to ensure the practice stores accident records relating to people employed and service users, in compliance with legislation and current guidance.