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Inspection Summary


Overall summary & rating

Updated 23 May 2019

We undertook a follow up focused inspection of Dalton Dental Care Limited on 29 April 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Dalton Dental Care Limited on 21 January 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Dalton Dental Care Limited on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

Our findings were:

Are services well-led?

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

The provider had made improvements in relation to the regulatory breach we found at our inspection on 21 January 2019.

Background

Dalton Dental Care Limited is in Huddersfield and provides NHS and private treatment to adults and children.

Due to the nature of the premises access for wheelchair users is not possible. Wheelchair users or those who cannot manage steps would be signposted to either the local community dental service or an accessible local dental practice. Car parking spaces are available near the practice.

The dental team includes four dentists and six dental nurses (one of whom also works as the practice manager). The practice has three treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Dalton Dental Care Limited is the principal dentist.

During the inspection we spoke with the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 9:00am to 5:30pm

Our key findings were:

  • Improvements had been made to the process for ensuring medical emergency equipment reflects nationally recognised guidance.
  • Improvements had been made to the systems and processes for managing the risks associated with fire, Legionella and the use of radiation.
  • Improvements had been made to the recruitment process.
Inspection areas

Safe

No action required

Updated 11 March 2019

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

The practice had systems and processes to provide safe care and treatment. They used learning from incidents to help them improve.

Staff received training in safeguarding people and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed most essential recruitment checks. There was no evidence of photographic identification for any staff and no evidence of the effectiveness of the Hepatitis B vaccination for two members of staff.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning and sterilising dental instruments. Improvements could be made to the process for storing re-usable dental instruments

Staff knew how to deal with medical and other emergencies. Not all medical emergency equipment was available as described in nationally recognised guidance.

Not all actions highlighted in the Legionella risk assessment had been addressed.

Effective

No action required

Updated 11 March 2019

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

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as first class, very good and excellent. The dentists discussed treatment with patients, so they could give informed consent and recorded this in their records.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

The provider supported staff to complete training relevant to their roles. The system to monitor staff training could be improved.

Caring

No action required

Updated 11 March 2019

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

We received feedback about the practice from 25 people. Patients were positive about all aspects of the service the practice provided. They told us staff were polite, considerate and friendly.

They said that they were given informative advice about dental treatment, and said their dentist listened to them. Patients commented that they made them feel at ease, especially when they were anxious about visiting the dentist.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 11 March 2019

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

The practice’s appointment system took account of patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. Due to the nature of the premises access for wheelchair users or those with limited mobility would not be possible. Wheelchair users of those with limited mobility were signposted to the community dental service or a local accessible dental practice. The practice had access to interpreter services.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints constructively.

Well-led

No action required

Updated 23 May 2019

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

The provider had made improvements to the management of the service. This included providing additional staff time available for management and administration, establishing clear roles and responsibilities for all the practice team. The improvements included:

  • Implementing a system to ensure medical emergency equipment reflected nationally recognised guidance.
  • Implementing checks on smoke alarms and firefighting equipment.
  • Addressing the risks associated with Legionella.
  • Addressing the risks associated with the use of radiation.
  • Obtaining photographic identification for all staff and evidence of immunity to Hepatitis B for the staff whom it was missing for at the initial inspection.
  • Updating the Control of Substances Hazardous to Health (COSHH) folder.
  • Reviewing the process for the storage and re-processing of re-suable dental instruments.