Archived: Tooth Booth Beaconsfield

Further to the outcome of a previous inspection, carried out in May 2016, we carried out an announced focused inspection relating to the well led provision of services on 6 September 2016 to ask the practice the following key questions;

Are services well-led in relation to governance; specifically staff training and systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors?

Our findings were:

Are services well-led?

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

Background

CQC inspected the practice on 12 May 2016 and asked the provider to make improvements regarding:

• Regulation 17 Health and Social Care Act (regulated activities) Regulations 2014 Good governance

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

Tooth Booth operates from commercial premises providing NHS and private dentistry for both adults and children. The practice is situated in Beaconsfield, Buckinghamshire.

The practice is based on the ground and first floor. The ground floor is accessible to wheelchair users, prams and patients with limited mobility. The practice has three dental treatment rooms, one of which is based on the ground floor. The practice has a separate decontamination room used for cleaning, sterilising and packing dental instruments.

The practice employs five dentists, one hygienist, three dental nurses, of which two are trainees, three reception staff and a practice manager. The practice opens Monday and Thursday between8.30am and 8pm, Tuesday, Wednesday and Friday between8.30am to 5.30pm and Saturday between 8.30am and 1pm.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. This is provided by an out-of-hours on call service provided by the 111 service.

There was no registered manager at the time of our inspection at this location. We were told that the current Practice Manager was going through the CQC registration process to become the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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.

The inspection was carried out by a CQC inspector.

Our key findings were:

• There were appropriate systems in place to meet health and safety regulations including risk assessment for fire and general health and safety criteria.
• Staff were up to date with their mandatory training and Continuing Professional Development (CPD).

We carried out an announced comprehensive inspection on 12 May 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 not providing well-led care in accordance with the relevant regulations.

Background

Tooth Booth operates from commercial premises providing NHS and private dentistry for both adults and children. The practice is situated in Beaconsfield, Buckinghamshire.

The practice is based on the ground and first floor. The ground floor is accessible to wheelchair users, prams and patients with limited mobility. The practice has three dental treatment rooms, one of which is based on the ground floor. The practice has a separate decontamination room used for cleaning, sterilising and packing dental instruments.

The practice employs five dentists, one hygienist, three dental nurses, of which two are trainees, three reception staff and a practice manager.The practice opens Monday and Thursday between8.30am and 8pm, Tuesday, Wednesday and Friday between8.30am to 5.30pm and Saturday between 8.30am and 1pm.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. This is provided by an out-of-hours on call service provided by the 111 service.

There was no registered manager at the time of our inspection at this location. We were told that the current Practice Manager was going through the CQC registration process to become the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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.

During our inspection we reviewed 16 CQC comment cards completed by patients and obtained the view of 15 patients on the day of our inspection.

The inspection was carried out by a lead inspector and a dental specialist adviser.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean.
• Infection control procedures followed published guidance.
• The practice had 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.
• 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 we spoke were committed to providing a quality service to their patients.
• Information from 16 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

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

• Ensure appropriate systems are in place to meet health and safety regulations including risk assessment for fire and general health and safety criteria and fire safety training for relevant staff.
• Ensure that a system for collating the records of training of relevant staff members is established.

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

• Review COSHH and RIDDOR policies to ensure they are practice specific.
• Produce an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
• Review the arrangements for the disposal of confidential documents to meet current legislation and guidance.
• Review the availability of a hearing loop for patients who are hard of hearing.
• Repair foot operated bin, cleaning cupboard door and air conditioning unit.

• Consider providing the hygienist with the support of an appropriately trained member of the dental team.