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Thames Street Dental Surgery

Inspection Summary


Overall summary & rating

Updated 6 October 2016

We carried out an announced comprehensive inspection on 8 September 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 Thames Street Dental Surgery is located in the London Borough of Kingston-upon-Thames. The premises are situated in a high-street location. There is one treatment room, a decontamination room, a reception room, a waiting room, a patient toilet, and a staff kitchen. These are distributed across the first and second floors of the building.

The practice provides NHS and private services to adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers and crowns and bridges.

The staff structure of the practice consists of a principal dentist, a dental nurse and a receptionist.

The practice opening hours are from 9.00am to 1.00pm on Monday, Wednesday and Friday, and from 9.00am to 6.00pm on Tuesdays and Thursdays.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person. 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 took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Eighteen people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

  • Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

  • There were effective systems in place to reduce and minimise the risk and spread of infection.

  • The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.

  • There were effective arrangements in place for managing medical emergencies.

  • Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced. The air compressor was booked for a service in the week following the inspection.

  • Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.

  • The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

  • The practice had implemented clear procedures for managing comments, concerns or complaints.

  • The provider had a clear vision for the practice and staff told us they were well supported by the management team.

  • There were some governance arrangements in place and infection control audits were effective in improving the quality and safety of the services. However, further improvements could be made to governance arrangements through the use of a wider range of policies, structured audits and risk assessments.

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

  • Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
  • Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
  • Review the practice’s safeguarding training; ensuring it covers both children and adults and all staff are trained to an appropriate level for their role and aware of their responsibilities.
  • Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
  • Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IRMER) 2000.
  • Review the practice’s use of audit protocols for various aspects of the service, such as radiography and dental care records, to help improve the quality of service. The practice should check that where applicable audits have documented learning points and the resulting improvements can be demonstrated.
  • Review the practice’s use of risk assessment processes, for example, in relation to fire or general health and safety, with a view to identifying and further reducing the risks to patients and staff.
Inspection areas

Safe

No action required

Updated 6 October 2016

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

The practice had systems in place to minimise the risks associated with providing dental services. The practice had policies and protocols, which staff were following, for the management of infection control, medical emergencies and dental radiography. There was a safeguarding lead and staff understood their responsibilities in terms of identifying and reporting any potential abuse. We found the equipment used in the practice was well maintained and checked for effectiveness.

Further improvements could be made through the implementation of a formal system for identifying, investigating and learning from incidents relating to the safety of patients and staff members.

Effective

No action required

Updated 6 October 2016

We found that this practice was providing effective care in accordance with

the relevant regulations.

The practice provided evidence-based care in accordance with relevant, published guidance, for example, from the General Dental Council (GDC)

. The practice monitored patients’ oral health and gave appropriate health promotion advice. Staff explained treatment options to ensure that patients could make informed decisions about any treatment. The practice worked well with other providers and followed up on the outcomes of referrals made to other providers.

Staff told us they were well-supported and supervised by the principal dentist. Staff engaged in continuous professional development (CPD) and were meeting all of the training requirements of the General Dental Council (GDC). The only exception was that the principal dentist needed to renew their safeguarding training at the time of the inspection. They confirmed that this had been completed two days after the inspection.

Caring

No action required

Updated 6 October 2016

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

the relevant regulations.

We received positive feedback from patients through comment cards and by speaking with patients on the day of the inspection. Patients felt that the staff were kind and caring; they told us that they were treated with dignity and respect at all times. We found that dental care records were stored securely and patient confidentiality was well maintained.

Responsive

No action required

Updated 6 October 2016

We found that this practice was providing responsive care in accordance with

the relevant regulations.

Patients generally had good access to appointments, including emergency appointments, which were available on the same day.

The culture of the practice promoted equality of access for all. The practice was not wheelchair accessible as the treatment room was situated on the second floor. However, the practice had made reasonable adjustments to the building to support people with limited mobility and redirected patients, who needed full wheelchair access, to other local practices.

There was a complaints policy in place; no complaints had been received in the past year.

Well-led

No action required

Updated 6 October 2016

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

The practice had clinical governance and risk management structures in place. These were well maintained and disseminated effectively to all members of staff. However, further improvements were needed in relation to the use of risk assessments and audits to monitor and improve performance. The principal dentist was responsive to our feedback in this area and implemented changes immediately after the inspection.

Staff described an open and transparent culture where they were comfortable raising and discussing concerns with the principal dentist or practice manager. They were confident in the abilities of the principal dentist and practice manager to address any issues as they arose.