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Inspection Summary


Overall summary & rating

Updated 9 November 2016

We carried out an announced comprehensive inspection on 15 September 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

Dental Practice 2 is situated in the Gosforth area of Newcastle, Tyne and Wear. It offers mainly NHS dental treatments to patients of all ages but also offers private options. The services include preventative advice and treatment, routine restorative dental care, orthodontics and dental implants.

The practice has three surgeries, a decontamination room, a waiting area, a reception area, a seminar room and an X-ray room. The reception area, waiting area, X-ray room and two of the surgeries are on the ground floor of the premises. The other surgery is on the first floor.

There is step free access to the premises and a ground floor accessible toilet. The practice is a training practice for newly qualified dentists or dentists from overseas (foundation dentist). Training practices have been approved by the regional postgraduate deanery to provide education supervision to foundation dentists.

There are six dentists (including a foundation dentist), one dental hygiene therapist, four dental nurses (including two trainee dental nurses) and a practice manager. The dental nurses also cover reception duties on a rota basis.

The opening hours are Monday to Wednesday from 9-00am to 5-30pm, Thursday from 8-30am to 5-00pm and Friday from 8-30am to 4-30pm.

The practice owner 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.

During the inspection we received feedback from 18 patients. The patients were positive about the care and treatment they received at the practice. Comments included that staff were friendly, helpful and charming. They also commented that the premises were always clean and hygienic and they felt safe and comfortable.

Our key findings were:

  • The practice was visibly clean and uncluttered.
  • The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
  • Staff were qualified and had received training appropriate to their roles.
  • Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
  • Dental care records showed that treatment was planned in line with current best practice guidelines.
  • Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
  • We observed that patients were treated with kindness and respect by staff.
  • Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.
  • The practice had an effective complaints system in place.
  • Patients were able to make routine and emergency appointments when needed.
  • The governance systems were effective.
  • There were clearly defined leadership roles within the practice and staff told us that they felt supported, appreciated and comfortable to raise concerns or make suggestions.
  • There were some gaps in the servicing history of the Orthopantomogram (OPG) machine.
  • There was an accessible toilet but this was partially obstructed by an X-ray machine.

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

  • Review the process for checking medical emergency equipment and medicines.
  • Review the availability of a plinth under the handwashing sink in the decontamination room.
  • Review the protocols and procedures for use of X-ray equipment giving due regard to guidance notes on the safe use of X-ray Equipment.
  • Establish whether the practice is in compliant with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.
  • Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010.
Inspection areas

Safe

No action required

Updated 9 November 2016

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

Staff told us they felt confident about reporting incidents, accidents and the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).

Staff had received training in safeguarding at the appropriate level and knew the signs of abuse and who to report them to.

Staff were suitably qualified for their roles and the practice had undertaken the relevant recruitment checks to ensure patient safety.

Patients’ medical histories were obtained before any treatment took place. The dentists were aware of any health or medication issues which could affect the planning of treatment. Staff were trained to deal with medical emergencies. There was no glucagon in the emergency drug kit and the adult AED pads were out of date. Both of these issues were addressed on the day of inspection.

The decontamination procedures were effective and the equipment involved in the decontamination process was regularly serviced, validated and checked to ensure it was safe to use. We saw the decontamination room cupboard was not sealed to the floor and the significant gap made cleaning this area difficult.

We noted there were some gaps in the servicing and quality assurance history of one of the X-ray machines. We also noted that some of the suggestions made at the acceptance test of the Orthopantomogram (OPG) machine had not been implemented.

Effective

No action required

Updated 9 November 2016

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

Patients’ dental care records provided comprehensive information about their current dental needs and past treatment. The dentists monitored any changes to the patient’s oral health and provided treatment when appropriate.

The practice followed best practice guidelines when delivering dental care. These included Faculty of General Dental Practice (FGDP), National Institute for Health and Care Excellence (NICE) and guidance from the British Society of Periodontology (BSP). The practice focused strongly on prevention and the dentists were aware of the ‘Delivering Better Oral Health’ toolkit (DBOH) with regards to fluoride application and oral hygiene advice.

Staff were encouraged to complete training relevant to their roles. The clinical staff were up to date with their continuing professional development (CPD).

Referrals were made to secondary care services if the treatment required was not provided by the practice.

Caring

No action required

Updated 9 November 2016

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

During the inspection we received feedback from 18 patients. Patients commented that staff were friendly, helpful and charming. They also commented that they felt safe and comfortable.

We observed the staff to be welcoming and caring towards the patients.

We observed privacy and confidentiality were maintained for patients using the service on the day of the inspection.

Staff explained that enough time was allocated in order to ensure that the treatment and care was fully explained to patients in a way which they understood.

The practice owner had set up a charity named “Smiles across Nepal”. This charity depends on donations and voluntary work. Volunteers travel to Nepal to provide emergency dental care and oral health education to individuals in Nepal.

Responsive

No action required

Updated 9 November 2016

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

The practice had an efficient appointment system in place to respond to patients’ needs. There were vacant appointments slots for urgent or emergency appointments each day.

Patients commented they could access treatment for urgent and emergency care when required. There were clear instructions for patients requiring urgent care when the practice was closed.

There was a procedure in place for responding to patients’ complaints. This involved acknowledging, investigating and responding to individual complaints or concerns. Staff were familiar with the complaints procedure.

The practice had made reasonable adjustments for patients with a disability or limited mobility to access dental treatment. We noted the accessible toilet was partially obstructed by an X-ray machine. The practice were aware of this issue and had a plan to move this piece of equipment.

Well-led

No action required

Updated 9 November 2016

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

There was a clearly defined management structure in place and staff felt supported and appreciated in their own particular roles. The practice manager was responsible for the day to day running of the practice. The practice owner was an effective clinical lead.

Effective arrangements were in place to share information with staff by means of monthly practice meetings which were well minuted for those staff unable to attend.

The practice regularly audited clinical and non-clinical areas as part of a system of continuous improvement and learning.

They conducted patient satisfaction surveys and were currently undertaking the NHS Friends and Family Test (FFT).