Archived: Central England Specialist Referral Centre

Updated 6 June 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 and to pilot a new inspection process being introduced by the CQC.

The inspection was carried out on 24 March 2016 by a CQC inspector. The team also included a specialist dental advisor.

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

As part of the inspection we spoke with people using the service, spoke with staff and observed and reviewed documents and policies. The practice only provided treatments on a private basis.

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 6 June 2016

We carried out an announced comprehensive inspection on 24 March 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

Central England Specialist Referral Centre treats private and patients referred by other general dentists for dental Implants, Endodontics, Periodontics and Prosthodontics. The practice is located in Longbridge, Birmingham.

Another surgery, (Mr Stewart Hawkins also known as Hawkins & Wilson Dental Practice) was also located on the first floor of premises. Both practices shared resources including staff. The policies, systems and procedures at both practices are centrally managed and are reflective across both practices. For example, there was one reception but with separate telephone lines. Both practices are registered individually with CQC and therefore, each site has an individual report.

Central England Specialist Referral Centre was located on the ground floor with two treatment rooms, one was used by the principal dentist and the other was used by a hygienist and an associate dentist. On the ground floor there were also two treatment rooms mainly used to treat patients that were referred to the Central England Specialist Referral Centre. On the first floor there were also two treatment rooms. There was one reception area on the ground floor and two waiting areas, one on the first floor and one on the ground floor.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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. The principal dentist (nominated individual) was away on the day of the inspection and the visit was facilitated by staff and another dentist who worked closely with the nominated individual. However, we spoke with them after the inspection in regards to their sedation practice.

We received feedback from patients through 13 completed comment cards and we also spoke with five patients on the day of the inspection. We received positive feedback from patients we spoke with and the comment cards also reflected this. The feedback received was reflective of both practices as mentioned above.

Our key findings were:

• There was an induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.
• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers, dental laser and the X-ray equipment.
• We found the dentists and dental hygienist regularly assessed each patient’s gum health and dentists took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.
• At our visit we observed staff were kind, caring and professional. Some staff had worked at the practice for a long time and demonstrated they knew patients well when they greeted them.

• There was an effective system in place to act on feedback received from patients and staff.

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

• Review the practice’s waste handling procedure to ensure external locked waste bins are secured.