Homefarm Dental

We carried out this announced inspection on 24 February 2020 under section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a Care Quality Commission, (CQC), inspector who was supported by a specialist dental adviser.

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 form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

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

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Homefarm dental practice is in Beaumont Leys, a suburb in north-western Leicester. It provides mostly NHS with some private dental care and treatment for adults and children. Services provided include general dentistry.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available in a free public car park within close distance of the practice.

The dental team includes three dentists and three dental nurses. Two of the dental nurses also work as receptionists. The practice has two treatment rooms; both of which are on ground floor level.

The practice is owned by a company and as a condition of registration must have a person registered with the CQC as the registered manager. Registered managers 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 registered manager at Homefarm dental practice is the principal dentist.

On the day of inspection, we collected 25 CQC comment cards filled in by patients.

During the inspection we spoke with one dentist and three dental nurses. We looked at practice policies and procedures, patient feedback and other records about how the service is managed.

The practice is open: Monday to Thursday from 9am to 5pm and Friday from 9am to 12.30pm. It closes for lunchtimes on Monday to Thursday between 12.30pm to 1.30pm. The practice also opens on some Saturdays.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. We noted some exceptions; these were addressed after our inspection.
• The provider had systems to help them manage risks to patients. We found that risk assessments required implementation in relation to the handling of sharps and for staff whose immunity to Hepatitus B was not yet known. The issues were addressed after our visit.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. This policy was subject to review at the time of our visit.
• The provider had staff recruitment procedures which reflected current legislation. References had not yet been returned for one newly appointed member of the team.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The principal dentist had been active in the local community to raise awareness of the importance of oral health. This included visits to a care home, community centres and religious temples.
• The practice was participating in the ‘Dental Check by One’ (DCby1) campaign. Their aim was to see more children as their teeth come through, or by their first birthday.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements. Policies were in the process of review as the provider was new to the practice ownership and they had moved to a new system of compliance.

There were areas where the provider could make improvements. They should:

• Implement an effective system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are identified and recorded as a result.
• Improve dental nurses’ understanding of the legal responsibilities regarding obtaining patient consent and the requirements of the Mental Capacity Act 2005. Ensure they are aware of their responsibilities under the Act as it relates to their role.
• Improve the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities.