Archived: Steep Hill Dental Practice

Updated 1 April 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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection took place on 25 February 2016 and was led by a CQC inspector and supported by a specialist dental advisor. Prior to the inspection, we asked the practice to send us some information that we reviewed. This included the complaints they had received in the last 12 months, their latest statement of purpose, and the details of their staff members including proof of registration with their professional bodies.

During the inspection, we spoke with the provider, dental nurse and receptionist and reviewed policies, procedures and other documents. We reviewed 11 comment cards that we had left prior to the inspection, for patients to complete, about the services provided at the practice.

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 1 April 2016

We carried out an announced comprehensive inspection on 25 February 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

Steep Hill Dental Practice is a single handed private dental practice close to the centre of Lincoln. The practice is in a building that has been adapted for the purpose of dentistry and has a large reception area with a wheelchair friendly desk. There are two treatment rooms, a decontamination room, a disabled toilet, a staff room and an office. There is also a room at the back of the building with staff toilet and changing area. There are two rooms at the front of the practice that are not been used but may be used in the future as the practice grows. The practice opened in June 2015 and has a growing patient base. Access to the practice areas are all on the ground floor. There is a pay and display car park within walking distance. The building is accessed from the street and there are four steps up to the main entrance. For those patients with limited mobility or wheelchairs there is access at the side which takes patients up a ramped area to a back entrance with a bell to alert reception staff.

There is one dentist that currently works part time, one dental nurse and one receptionist who are both full time. There is also a dental hygienist who is the owner and registered manager of the practice. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered dentists, they are ‘registered persons’. 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.

The practice provides private dental treatment to adults and to children. The practice is open Monday to Friday from 8.30am to 5pm with the practice closing at 4pm Fridays. The practice also closes for lunch 1pm to 2pm daily. The practice also opens Saturday 8.30am to 12pm twice a month.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 11 patients about the services provided. The feedback reflected positive comments about the staff and the services provided. Patients commented that the practice was clean and tidy and that it was calming and friendly. They said that they found the staff offered an efficient and professional service, were polite, helpful and caring. Patients said that explanations about their treatment were clear and that they were given time and all options were fully explained. Patients who were nervous commented how the staff were understanding and patient; they were made to feel at ease and that any questions were answered.

Our key findings were:

• There was a process in place for reporting and learning from incidents, accidents and near misses.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in place and staff had access to personal protective equipment.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks.
• Patients were treated with dignity and respect.Their confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum where possible.
• The practice was well-led and staff felt involved and worked as a team.
• Staff had been trained to deal with medical emergencies.
• Governance systems were effective and policies and procedures were in place to provide and manage the service.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• All staff were clear of their roles and responsibilities.
• The practice did not have an automated external defibrillator (AED)
• Audits had not taken place however the practice had not been open for a full year.
• Infection control audit had not taken place at the recommended intervals however the practice completed one on the day of inspection.
• The practice did not have a legionella risk assessment in place however this was completed the week after the inspection.

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

• Review availability of 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.
• Implement a plan for future audits and assessments at recommended intervals.
• Monitor equipment purchased to ensure that servicing and checks of equipment are completed in recommended timescales.