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Inspection Summary


Overall summary & rating

Updated 15 October 2015

We carried out an announced comprehensive inspection on 5 August 2015 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

Park Dental Care is located close to the centre of Nottingham. There are good public transport links with car parking at the Broadmarsh shopping centre and nearby street parking. The bus station is also a short walk away.

The practice provides private dental services and treats both adults and children. There are three dentists, two dental therapists and three dental nurses plus one trainee dental nurse. In addition the practice has an office manager and a clinical manager (who is also a dental nurse) and a receptionist to provide support to the dental team.

The practice opening hours are: Monday: 10:30 am to 8:00 pm; Tuesday 8:30 am to 4:00 pm; Wednesday 8:30 am to 7:00 pm; Thursday 8:30 am to 6:00 pm Friday 8:30 am to 4:00 pm and Saturday 8:30 am to 1:00 pm.

We viewed 27 Care Quality Commission (CQC) comment cards that had been completed by patients, about the services provided. All 27 comment cards had wholly positive comments about the practice and several made particular reference to the staff. Ten comment cards talked about safety, and feeling safe. Five cards described Park Dental Care as the best dental care the patients had ever received. In addition we spoke with four patients who again provided positive feedback about the practice. Comments particularly focussed on the professionalism of the staff, and how well cared for patients felt.

The principal dentist operates a satellite clinic which provides an orthodontic service from Dovebank which is located in Ashbourne, Derbyshire. Patients are self-referred and seen under private contract. The dentist provides this service at the Dovebank practice outside normal office hours for patients’ convenience. The Dovebank practice is located on the ground floor with level access.

We did not inspect the satellite clinic at Dovebank practice as part of this inspection.

Our key findings were:

  • The practice had a system for recording and analysing significant events and complaints and sharing learning with staff.
  • Staff had received safeguarding and whistle blowing training and knew the procedures to follow to raise any concerns.
  • There were sufficient numbers of suitably qualified staff to meet patients’ needs.
  • Staff had been trained to handle emergencies and appropriate equipment and medicines were readily available.
  • Infection control procedures were in place and the practice mostly followed national guidance.
  • Patient’s care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
  • Patients received clear explanations about their proposed treatment, costs, options and risks and were involved in making decisions about it.
  • Patients were treated with dignity and respect and confidentiality was maintained.
  • The appointment system met patients’ needs.
  • The practice was well-led and staff worked as a team.
  • Governance systems were effective and there was a range of clinical and non-clinical audits to monitor the quality of services.

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

  • Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’
Inspection areas

Safe

No action required

Updated 15 October 2015

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

The practice was not completing and documenting six monthly audits of their decontamination processes as identified in national guidance.

The practice had procedures in place to investigate and respond to significant events and complaints. There was a separate system to record details of accidents. The practice could demonstrate that staff had learnt from all of these.

The practice had a safeguarding vulnerable adults and children policy and procedures. Staff demonstrated an awareness of the signs of abuse and knew their duty to report any concerns about abuse.

Dentists were using latex free rubber dams when carrying out root canal treatments in line with guidance from the British Endodontic Society.

The practice had a whistle blowing policy for staff to raise concerns in confidence. Staff knew the procedure for whistleblowing and who they could speak with about any concerns.

The practice had procedures and equipment for dealing with medical emergencies. There was an emergency medical kit available including emergency medicines, oxygen and an automated external defibrillator (AED) as recommended by the UK resuscitation council.

Staff recruitment procedures were robust, and the necessary checks had been completed for staff working at the practice.

The practice mostly followed national guidance from the Department of Health in respect of infection control. There were the necessary procedures and equipment available for effective infection control.

The practice was unable to demonstrate that six monthly audits of infection control procedures had taken place as recommended in relevant guidance.

X-rays were carried out in line with the Ionising Radiation Regulations 1999 (IRR 99).

Effective

No action required

Updated 15 October 2015

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

Patients were assessed at the start of each consultation to update their medical history. The results of assessments were discussed with patients and treatment options and costs were explained. Patients said they were involved in those discussions.

Dentists were aware of National Institute for Health and Care Excellence (NICE) guidelines particularly in respect of recalls of patients and anti-biotic prescribing.

Advice was given to patients on how to maintain good oral hygiene and the impact of diet, tobacco and alcohol consumption on oral health.

There were enough suitably qualified and experienced staff to meet patients’ needs. Staff were encouraged to update their training, and maintain their continuing professional development (CPD).

Referrals were made to other services in a timely manner when further treatment or treatment outside the scope of the practice was required.

Staff were aware of the Mental Capacity Act (MCA) 2005, and consent was carried out in line with relevant legislation including the MCA.

Caring

No action required

Updated 15 October 2015

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

Comments from patients at the practice were positive about the care and treatment they received. Patient’s confidentiality was maintained at all times. Staff treated patients with privacy, dignity and respect.

Patient records, both paper and electronic were held securely either under lock and key or password protected on the computer.

Responsive

No action required

Updated 15 October 2015

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

The practice provided patients with information about the services they offered on their website and in the practice. The appointment system responded to patients’ routine needs and when they required urgent treatment.

Longer appointment times were available for patients who required extra time or support.

The practice building was suitable for those who had impaired mobility. This included level access, a downstairs toilet which was accessible to people with restricted mobility.

The practice opening times included late evening surgeries and Saturday mornings to meet the needs of patients who worked or were in full time education.

There was a complaints policy and procedure, and patients’ complaints were responded to in a timely manner. Learning from complaints was shared with the staff team.

Well-led

No action required

Updated 15 October 2015

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

The principal dentist took an active lead in the day to day running of the practice. The practice had arrangements in place for monitoring and improving the services provided for patients. There were robust governance arrangements in place.

The practice had an open and honest culture. Staff told us that they could speak with the principal dentist if they had any concerns. We were told that there was a focus at the practice of delivering high quality care.

The practice’s philosophy put the patient first, and they were at the heart of everything the practice did. We saw that dentists reviewed their clinical practice and introduced changes to make improvements.

The comments in the 27 Care Quality Commission (CQC) comment cards we received and the four patients we spoke with said that they were happy with the care and treatment they received.

Patients could give feedback at any time they visited.