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Inspection Summary


Overall summary & rating

Updated 22 June 2016

We carried out an announced inspection of this practice on 13 October 2015. Breaches of legal requirements were found. After the inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their plan and to confirm they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Mr. John Glassby - Kingston Square on our website at www.cqc.org.uk

Our findings were:

Are services well-led?

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

Background

Mr. John Glassby - Kingston Square is situated in the town Hull, Humberside. The surgery provides a comprehensive range of dental services and offers private treatment options; the services include preventative advice and routine restorative dental care.

The practice has one surgery, a decontamination room, an X-ray processing room, a waiting area and a reception area. Treatment and waiting rooms are all situation on the ground floor of the premises.

The practice is open on flexible days between Monday – Friday 10:30 am – 17:30 pm and two Saturdays per year.

Our key findings were:

  • The practice had reviewed their protocol for completing dental care records giving due regard to guidance provided by the Faculty of General Dental Practice in respect of clinical examinations and record keeping.
  • The practice had completed audits including x-ray, infection prevention and control and clinical record keeping. All audits had a documented action plan with guidance on how the practice would implement the improvements.
  • A new weekly system had been implemented to check the availability of medicines to manage medical emergencies giving due regard to the guidelines issued by the Resuscitation Council UK – the body responsible for setting standards for cardiopulmonary resuscitation in the United Kingdom. All equipment and medicines had been ordered.

Inspection areas

Safe

No action required

Updated 24 December 2015

We found that this practice was providing safe care in accordance with the relevant regulations. However we found areas that required improvements relating to the safe provision of treatment. This was because the provider did not have all necessary equipment to deal with medical emergencies in the event of an emergency occurring.

The practice did not have effective systems and processes in place to ensure that all care and treatment was carried out safely. For example, some emergency equipment and medicines were not all in date. This was not in accordance with the British National Formulary (BNF) and Resuscitation Council UK guidelines. The practice did not have the emergency medicine Midazolam. This was brought to the attention of the registered provider and new equipment was ordered whilst the inspection was taking place and evidence of this was seen.

Staff had received training in safeguarding patients; they knew how to recognise the signs of abuse and how to report them although this training was not to the required level two. Staff had also received training on infection control in October 2015. There was a decontamination room and guidance for staff to provide effective decontamination of dental instruments.

Patients' medical histories were obtained both written and verbally before any treatment took place. This provided the dentist with up to date information about any health or medication issues which could affect the planning of treatment.

Staff were recruited, suitably trained and skilled to meet patients’ needs and there were sufficient numbers of staff available at all times. Staff induction policies were in place; however there had not been a new member of staff for some time.

We reviewed the legionella risk assessment dated February 2015; all tests were in place.

Effective

No action required

Updated 24 December 2015

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

Patients' dental care records did not always provide comprehensive information about their current dental needs. Dental care records which we reviewed on the day of inspection were not thorough, did not include discussions about treatment options and X-rays were not always reported, justified or graded.

Consultations were carried out in line with best practice guidance from the Faculty of General Dental Practice (FGDP). For example, patients were recalled after an agreed interval, for an oral health review, during which their medical histories and examinations were updated and recorded. Any changes in risk factors were also discussed although this was not always recorded.

Patients were referred to other specialist services in a timely manner and all returning information was reviewed. Patients were offered a follow up appointment at the practice to ensure continuity of care.

Staff were supported in delivery of effective care through training and development. The clinical staff provided clear evidence to support their continuous professional development (CPD). They were supported to meet the requirements of their professional registration and systems were in place to monitor this.

Caring

No action required

Updated 24 December 2015

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

Comments from the 55 completed CQC comment cards included statements saying the staff were caring, friendly, helpful and professional.

We observed patients' privacy and confidentiality were maintained at all times in the waiting room and reception area.

Staff explained that enough time was allocated in order to ensure that the treatment and care was fully explained to patients in a way which patients understood.

We observed patients being treated with respect and dignity during interactions at the reception desk and whilst on the telephone.

Responsive

No action required

Updated 24 December 2015

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

Patients could access routine treatment and urgent care when required. The practice offered daily access for patients experiencing dental pain which enabled them to receive treatment quickly and they had a system in place to receive messages left at the practice out of working hours to enable contact with patients.

The practice had a complaints process; however, this was not easily accessible to patients who wished to make a complaint. Patients we spoke to on the day confirmed they did not know how to complain about the services or who to if the need arose.

Well-led

No action required

Updated 22 June 2016

We found that this practice was providing well-led care in accordance with

the relevant regulations.

Since the last inspection on 13 October 2015 the practice had effective systems and processes in place to ensure that all care and treatment was carried out safely. For example, the practice had implemented policies and procedures around the completion of dental care records and a new system to review the medical emergency equipment and drugs.

The practice had now completed various audits to monitor its performance and help improve the services offered. The audits included dental care records, infection prevention and control and X-rays. The X-ray audit findings were now within the guidelines of the National Radiological Protection Board (NRPB).