Archived: T T & M M Brown

Updated 12 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection took place on 31 August 2016. It was led by a CQC inspector and supported by a dental specialist advisor.

We informed NHS England and Healthwatch England that we were inspecting the practice; however we did not receive any information of concern from them.

During the inspection, we spoke with the registered provider, three dentists, three dental nurses, one receptionist and the practice manager.

We reviewed policies, protocols, certificates and other documents to consolidate our findings.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 12 October 2016

We carried out an announced comprehensive inspection on 31 August 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

Browns’ Dental Surgery is a family-run dental practice which provides predominantly NHS treatment to patients of all ages. The practice is situated on the second floor of a large health centre within Washington town centre. There are three treatment rooms, a dedicated decontamination room for sterilising dental instruments and a shared staff kitchen. There is limited car parking within the basement of the health centre though there are ample spaces in the shopping complex next to the practice. Access for wheelchair users is possible either via the basement lift where disabled car parking spaces are allocated or using the ramp and entrance located on the second floor.

The practice is open Monday to Friday 0900 -1630.

The dental team is comprised of two principal dentists, three associate dentists, a practice manager, two receptionists (one of whom is also a qualified dental nurse) and four qualified dental nurses.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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 reviewed 32 CQC comment cards on the day of our visit; patients were very positive about the staff and standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• The practice was well organised, visibly clean and free from clutter.
• An Infection prevention and control policy was in place. We saw the sterilisation procedures followed recommended guidance.
• The practice had systems for recording incidents and accidents.
• Practice meetings were used for shared learning.
• The practice had a safeguarding policy and staff were aware on how to escalate safeguarding issues for children and adults should the need arise.
• Staff received annual medical emergency training.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Patients could access urgent care when required.
• Complaints were dealt with in an efficient and positive manner.

There were areas where the provider could make improvements and should:

• Review the practice's recruitment policy and procedures to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held. This includes making appropriate notes of verbal reference taken and ensuring recruitment checks, including references, are suitably obtained and recorded.
• Review the practice's procedures for undertaking six-monthly infection prevention and control audits as recommended by the Department of Health: Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices.
• Review the practice’s procedures for undertaking patient and staff satisfaction surveys to help improve the quality of service.
• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.
• Review the practice responsibilities in regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 to ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review the practice medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.