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Inspection Summary


Overall summary & rating

Updated 26 April 2019

We carried out this announced inspection on 14 March 2019 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 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 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

Frays Dental Practice is in the London Borough of Hillingdon and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including 3 for blue badge holders, are available at the rear of the practice.

The dental team includes two principal dentists, six associate dentists, an oral surgeon, specialist periodontist, three hygienists, three dental nurses, five trainee dental nurses, two receptionists and a practice manager.

The practice is owned by a Partnership 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 Frays Dental Practice is one of the principal dentist

On the day of inspection, we collected 36 CQC comment cards filled in by patients.

During the inspection we spoke with the principal dentists, one dentist, one dental nurse, one hygienist, one receptionist and the seditionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

  • Monday to Thursday 8.45 am to 8pm
  • Friday 8am to 6pm
  • Saturdays 8am to 2pm

Our key findings were:

  • The practice appeared clean and well maintained.
  • The practice had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The practice had systems to help them manage risk.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had thorough staff recruitment procedures.
  • 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 were providing preventive care and supporting patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • The practice had effective leadership and a culture of continuous improvement.
  • Staff felt involved and supported and worked well as a team.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice dealt with complaints positively and efficiently.
  • The practice had suitable information governance arrangements.

We identified an area of notable practice.

The practice had its own comprehensive training pathway for trainee dental nurses. Which

Many staff members who had started at trainee level had progressed to become head nurses or practice managers.

The training was designed to prepare and support dental nurses for the national qualification in dental nursing.

Training folders for all trainee nurses were specially designed to cover the first 12 weeks in practice. These included tests on what staff had learnt and importantly feedback and testimonials from dentists who they had worked with, which was used to confirm competency at particular tasks.

The training was supplemented by a series of quizzes, exams and training manuals that trainee dental nurses could reference at any time to remind them of their learning.

To date the practice had a 100% pass rate and four dental nurses had moved on to higher qualifications or were working at other practices in a higher role.

At present there were five dental nurses working towards the National Examining Board for Dental Nurses Qualification.

This is notable practice because of the provider’s commitment and support to staff development.

Inspection areas

Safe

No action required

Updated 26 April 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 and complaints to help them improve.

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

Staff were qualified for their roles and the practice completed essential recruitment checks.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had suitable arrangements for dealing with medical and other emergencies.

Effective

No action required

Updated 26 April 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 professional, excellent and caring

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 practice supported staff to complete training relevant to their roles and had systems to help them monitor this.

The staff were involved in quality improvement initiatives such as clinical audits and peer review as part of the practice’s approach in providing high quality care.

Caring

No action required

Updated 26 April 2019

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

We received feedback about the practice from 36 people. Patients were positive about all aspects of the service the practice provided. They told us staff were respectful, friendly and understanding

They said that they were given helpful, detailed and clear explanations 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 26 April 2019

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

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. This included providing facilities for disabled patients and families with children. The practice had access to interpreter services.

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

Well-led

No action required

Updated 26 April 2019

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

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided. There was a clearly defined management structure and staff felt supported and appreciated.

The practice team kept complete patient dental care records which were clearly written and stored securely.

The provider monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.