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Wigston House Dental Practice

Inspection Summary


Overall summary & rating

Updated 7 August 2017

We carried out this announced inspection on 8 June 2017 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information for us to take into account.

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

Wigston House Dental Practice is in Wigston, a town in Leicester and provides NHS and private treatment to patients of all ages.

There is a single step at the front entrance of the building. Measures have been taken to enable people who use wheelchairs and pushchairs access to the practice if required. There is some limited car parking at the rear of the premises and free car parking is also available on the street where the practice is based. There is a free public car park within short walking distance.

The dental team includes three dentists (one is a trainee dentist), three dental nurses, one therapist and a receptionist. The practice are currently recruiting for a nurse and receptionist. The practice does not currently employ a practice manager following the staff member leaving in April 2017.

The practice has four treatment rooms with one located on the ground floor.

The practice is owned by an individual who is the principal dentist there. They 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 principal dentist is an approved dental trainer for dentists new to general dental practice. The practice currently has one trainee dentist working in the practice.

On the day of inspection we collected 15 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

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

The practice is open Monday and Tuesday from 11am to 2.30pm and 3.15pm to 7.15pm, Wednesday and Thursday from 8am to 12pm and 12.45pm to 4pm. On alternating Fridays, the practice is open from 8am to 12pm and 12.45pm to 4pm or 9.30am to 1.15pm and 2pm to 5.45pm. The practice also opens one Saturday per month.

Our key findings were:

  • The practice ethos included the provision of high quality dental services to the local community in a professional, friendly and inviting environment.
  • There was evidence of some effective leadership. We found areas where management arrangements required strengthening however.
  • Staff had been trained to deal with emergencies, but we found the practice did not hold all appropriate medicines and equipment necessary to respond in the event of a medical emergency.
  • The practice appeared clean and well maintained.
  • Staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
  • Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines although we noted exceptions in relation to some record keeping.
  • The practice demonstrated awareness of the needs of the local population and took these into account when delivering the service.
  • Staff received most training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
  • Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
  • The practice asked patients for feedback about the services they provided. Information we obtained from 15 Care Quality Commission cards provided positive feedback. We did not receive any negative feedback about the practice.

There were areas where the provider could make improvements. They should:

  • Review their governance arrangements to effectively support the management of the service. This should include improvements in policy, procedures and identifying risks involving clinical processes.

  • Review the practice’s audit protocols to ensure audits of various aspects of the service, such as dental record keeping, stock checking and infection prevention and control are undertaken at regular intervals to help improve the quality of service. Practice should also ensure, that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.

  • Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

  • Review staff awareness of Gillick competence and how this relates to their role.

Inspection areas

Safe

No action required

Updated 7 August 2017

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

The practice had some systems and processes to provide safe care and treatment but we found areas that required strengthening. The practice had not recorded all accidents which had occurred.

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 most essential recruitment checks. We noted exceptions in relation to the provider obtaining evidence of staff identity and evidence of previous satisfactory employment at the point of recruitment.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments. We noted that infection prevention control audits had been undertaken annually however, guidance recommended these audits to be undertaken twice yearly.

The practice had some suitable arrangements for dealing with medical and other emergencies but we found a number of exceptions on the day of our inspection which meant the practice were not prepared for all emergencies.

Effective

No action required

Updated 7 August 2017

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 excellent, thorough and professional. The dentists discussed treatment with patients so they could give informed consent.

The practice had arrangements when patients needed to be referred to other dental or health care professionals. On the day of our inspection, we found that arrangements required strengthening to ensure that all referrals were monitored, once sent. The provider implemented a new monitoring procedure after our inspection took place.

The practice supported staff to complete training relevant to their roles. We noted that formalised staff training in the Mental Capacity Act 2005 and Gillick competence had not taken place however.

Caring

No action required

Updated 7 August 2017

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

the relevant regulations.

We received feedback about the practice from 15 people who completed CQC comment cards. Patients were positive about all aspects of the service the practice provided. They told us staff were welcoming, friendly and polite. They said that they were given helpful and informative explanations about dental treatment and said their dentist listened to them. Patients commented that they made them feel at ease.

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 7 August 2017

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 and had arrangements to help patients with hearing loss.

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 7 August 2017

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

The practice had some 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. However, we noted there were also areas of improvement required in governance arrangements. These included ensuring that all risks were identified, addressed promptly and appropriate action taken to manage and reduce risks from occurring.

There was a management structure and staff we spoke with felt supported.

The practice team kept patient dental care records which were written or typed and stored securely.

The practice had quality assurance processes aimed at encouraging learning and continuous improvement. We found areas which required strengthening such as reviewing action plans from audits undertaken.

We saw evidence that the practice listened to the views of patients and staff.