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Inspection carried out on 15/06/2017

During an inspection looking at part of the service

Further to the outcome of a previous inspection, carried out in February 2017, we carried out an announced focused inspection relating to the well led provision of services on 15 July 2017 to ask the practice the following key question;

Are services well-led in relation to governance; specifically to storage of staff recruitment and training records, management of fire safety and storage of substances subject to COSHH regulations?

Our findings were:

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

Background:

CQC inspected the practice on 14 and 15 February 2017 and asked the provider to make improvements regarding:

• Regulation 17 HSCA (RA) Regulations 2014 Good Governance

We checked this area as part of this focused inspection and found this had been resolved.

You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Oasis Dental Care Southern – Oxford on our website at www.cqc.org.uk.

Oasis Dental Care Southern Oxford is a dental practice providing NHS and private treatment for both adults and children. The practice is based in a converted domestic dwelling in Oxford.

The practice has seven dental treatment rooms two of which are based on the ground floor and a separate decontamination area used for cleaning, sterilising and packing dental instruments. The ground floor is accessible to wheelchair users, prams and patients with limited mobility via a ramp.

The practice employs seven dentists, one hygienist, seven nurses, two trainee nurses, four receptionists and a practice manager.

The practice’s opening hours are between 8.30am and 7pm from Monday to Thursday, 8.30am and 4pm on Friday and 9am and 2pm on Saturday.

Arrangements are in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service, via 111.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, 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. At the time of our inspection the registered manager was away from the practice on long term leave. A manager from another of the provider’s locations was managing the service meanwhile.

Our key findings were:

  • Effective systems were in place to manage fire safety.
  • Substances subject to COSHH regulations were stored securely.
  • Staff recruitment and training records were collated and stored securely.

Inspection carried out on 14-15/02/2017

During a routine inspection

We carried out an announced comprehensive inspection on 14 and 15 February 2017 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 not providing well-led care in accordance with the relevant regulations.

Background

Oasis Oxford is a dental practice providing NHS and private treatment for both adults and children. The practice is based in a converted domestic dwelling in Oxford.

The practice has seven dental treatment rooms two of which are based on the ground floor and a separate decontamination area used for cleaning, sterilising and packing dental instruments. The ground floor is accessible to wheelchair users, prams and patients with limited mobility via a ramp.

The practice employs seven dentists, one hygienist, seven nurses, two trainee nurses, four receptionists and a practice manager.

The practice’s opening hours are between 8.30am and 7pm from Monday to Thursday, 8.30am and 4pm on Friday and 9am and 2pm on Saturday.

Arrangements are in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service, via 111.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, 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.

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 six patients. These provided a mainly positive view of the services the practice provides. Patients commented on the high quality of care, the caring nature of all staff, the cleanliness of the practice and the overall high quality of customer care. One patient however, commented about the high turnover of dentists which they felt resulted in them not being able to build a lasting relationship with a dentist.

We obtained the views of 18 patients on the day of our inspection.

Our key findings were:

  • Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
  • There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
  • The practice appeared clean, infection control procedures were effective and the practice followed published guidance.
  • The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
  • There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
  • Most dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
  • The service was aware of the needs of the local population and took these into account in how the practice was run.
  • Patients could access treatment and urgent and emergency care when required.
  • Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the company.
  • Patient feedback before and during our inspection gave us a positive picture of a friendly, caring, professional and high quality service
  • Staff we spoke with felt supported by the senior clinicians and practice manager and was committed to providing a quality service to their patients but felt overstretched as there were not adequate numbers of dentists to meet patient demand.
  • Although the care provided by the dentists led to good patient outcomes, there were shortfalls in the way the clinical governance systems and processes underpinning the clinical care were operating.

We identified regulations that were not being met and the provider must:

  • Ensure an effective system is established to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities. For example, fire safety management and the secure storage of products which come under COSHH regulations.
  • Ensure the training, learning and development needs of staff members are stored securely.
  • Ensure staff recruitment records are stored securely.

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

  • Provide an annual statement in relation to infection prevention control having due regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
  • Review the NHS Choices and the practice websites so that they contain up to date information about the practice opening hours, staff employed and feedback provided by patients via NHS Choices is responded to.
  • Review display of information related to staff working at the practice taking into account guidance issued by the General Dental Council. Review the storage arrangements of the emergency medicines and lifesaving equipment so that they are stored in a more suitable location in the practice.
  • Review the security of the decontamination room.
  • Review arrangements for the position of a printer on the reception desk to improve wheelchair user’s access.
  • 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.
  • Reinstate practice information leaflets.

Inspection carried out on 16 March 2012

During a routine inspection

The people we spoke with were generally happy with the service they received from the practice. They felt safe and had been consulted about and consented to their treatment. People told us they had been asked about their medical history and had a full dental examination. People said they had been given aftercare advice following treatment.