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Inspection Summary


Overall summary & rating

Updated 26 August 2016

We carried out an unannounced comprehensive inspection on 13 July 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

The practice is located in premises close to Grantham town centre. The practice provides a mixture of private and NHS dental treatments. Approximately 70% of the treatment is provided to NHS patients. There is a small car park to the front of the practice and disabled parking on the roadside outside for blue badge holders. There are twelve treatment rooms all of which are located on the ground floor.

The practice was first registered with the Care Quality Commission (CQC) in July 2011. The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are - Monday: 8:45 am to 7 pm; Tuesday 8:45 am to 6:30 pm; Wednesday: 8:45 am to 5 pm; Thursday: 8:45 am to 5 pm; Friday: 8:45 am to 4 pm and alternate Saturdays from 9 am to 1 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients could telephone the NHS 111 telephone number.

One of the partners is 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 practice has ten dentists; three oral surgeons; one orthodontist; and one practitioner with a special interest in orthodontics. four dental hygienists; twelve qualified dental nurses; two trainee dental nurses; six receptionists and a practice manager.

We received positive feedback from three patients about the services provided. This was by speaking with patients in the practice.

Our key findings were:

  • There were systems in place to record accidents, significant events and complaints, and where learning points were identified these were shared with staff.
  • The practice provided a sedation service for nervous patients or those requiring oral surgery. The guidance relating to sedation was being followed.
  • The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.
  • The practice was visibly clean and tidy.
  • The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
  • Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Dentists identified the different treatment options, and discussed these with patients.
  • Patients’ confidentiality was maintained.
  • Patients said they had no difficulty getting an appointment that suited their needs.
  • Patients we spoke with at the practice provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect.
  • The practice was well equipped and provided a relaxed atmosphere for patients.
  • There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns.
  • Patients were able to express their views and comments, and the practice listened to those views and acted upon them.
Inspection areas

Safe

No action required

Updated 26 August 2016

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

The practice was visibly clean and spacious.

The practice provided a sedation service for nervous patients or those requiring oral surgery. This was both through intravenous medication into the patients’ arm or through inhalation of a gas to help the patient relax. The guidance: Conscious Sedation in the Provision of Dental Care (Department of Health 2003) was being followed. The practice was working towards meeting the latest guidance published in April 2015 from the Royal College of Surgeons and the Royal College of Anaesthetists: ‘Standards for Conscious Sedation in the Provision of Dental care.’

All staff had received up-to-date training in safeguarding vulnerable adults and children. There were clear guidelines for reporting concerns and the practice had a lead member of staff to offer support and guidance over safeguarding matters. Staff knew how to recognise the signs of abuse, and how to raise concerns when necessary.

The practice had emergency medicines and oxygen available, and an automated external defibrillator (AED). Regular checks were being completed to ensure the emergency equipment was in good working order.

The practice had infection control procedures to ensure that patients were protected from potential risks. Regular audits of the decontamination process were as recommended by the current guidance.

Effective

No action required

Updated 26 August 2016

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

All patients were clinically assessed by a dentist before any treatment began. The practice used a recognised assessment process to identify any potential areas of concern in a patient’s mouth including their soft tissues (gums, cheeks and tongue).

The practice was following National Institute for Health and Care Excellence (NICE) guidelines for the care and treatment of dental patients. Particularly in respect of patient recalls, lower wisdom tooth removal and the prescribing of antibiotics for patients at risk of infective endocarditis (a condition that affects the heart).

The practice had systems in place for making referrals to other dental professional when it was clinically necessary.

Caring

No action required

Updated 26 August 2016

We found that this practice was providing caring services in accordance with

the relevant regulations.

Patient confidentiality was maintained and electronic dental care records were password protected.

Feedback from patients identified staff were friendly, polite and professional. Feedback indicated that the practice treated patients with dignity and respect.

There were systems for patients to be able to express their views and opinions.

Responsive

No action required

Updated 26 August 2016

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

Patients who were in pain or in need of urgent treatment could usually get an appointment the same day.

Patient areas of the practice were located on the ground floor. There was good access for patients with restricted mobility, including level access. A disabled access audit in line with the Equality Act (2010) had been completed to consider the needs of patients with restricted mobility.

There were arrangements for emergency dental treatment outside of normal working hours, including weekends and public holidays which were clearly displayed in the waiting room, and the practice leaflet.

There were systems and processes to support patients to make formal complaints. Where complaints had been made these were acted upon, and apologies given when necessary.

Well-led

No action required

Updated 26 August 2016

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

There was a clear management structure at the practice. Staff were aware of their roles and responsibilities within the dental team, and knew who to speak with if they had any concerns.

The practice had a robust system for carrying out regular audits to assess the safety and effectiveness of the services provided.

Patients were able to express their views and comments, and the practice listened to those views and acted upon them.

Staff said they could speak with a senior colleague if they had any concerns.