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Inspection Summary


Overall summary & rating

Updated 14 May 2019

We carried out this announced inspection on 23 April 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

Norfolk Dental Specialists is a well-established practice in Norwich city centre that offers private treatment to about 3,000 adults. The practice specialises in periodontics, endodontics, implants and dental hygiene.

The dental team includes six dentists, eight dental nurses, four hygienists, a receptionist and a practice manager. There are four treatment rooms. There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available.

The practice opens from 8.30 am to 5pm Mondays, Wednesday and Fridays, and on Tuesdays and Thursdays from 8.30 am to 6pm. It also opens on Saturdays from 9am to 3pm.

The practice is owned by a company 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 is the practice manager.

On the day of inspection, we collected 30 CQC comment cards filled in by patients and spoke with two other patients. We spoke with two dentists, two dental nurses, the receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.
  • Patients received their care and treatment from well supported staff, who enjoyed their work.
  • Members of the dental team were up-to-date with their continuing professional development and were supported to meet the requirements of their professional registration.
  • The practice provided good preventive care and supported patients to ensure better oral health.
  • Complaints were well managed and the practice responded empathetically to patients’ concerns.
  • The practice had effective leadership and a culture of continuous audit and improvement.

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

  • Review management systems to ensure an accurate account of all medicines held in the practice is kept and that medicines labels contain information about the practice’s address.

  • Review the storage of dental card records to ensure they are held securely.


Inspection areas

Safe

No action required

Updated 14 May 2019

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

The practice had good arrangements in place for essential areas such as managing medical emergencies, clinical waste, assessing risk and dental radiography (X-rays). Staff used learning from incidents and complaints to help them improve.

Staff had received safeguarding training and were aware of their responsibilities regarding the protection of children and vulnerable adults.

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

There were sufficient numbers of suitably qualified staff working at the practice and recruitment procedures were robust.

Effective

No action required

Updated 14 May 2019

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

Staff had the skills, knowledge and experience to deliver effective care and treatment. The dental care provided was evidence based and focussed on the needs of the patients. The practice used current national professional guidance including that from the National Institute for Health and Care Excellence (NICE) to guide their practice. Many staff had additional professional training to enhance their skills and knowledge.

The dentists discussed treatment options with patients so they could give informed consent and recorded this in their records.

Caring

No action required

Updated 14 May 2019

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

Patients were positive about all aspects of the service the practice provided and spoke highly of the treatment they received, and of the staff who delivered it. Patients told us that staff were caring and empathetic and took time to explain their treatment to them thoroughly.

Staff gave us specific examples of where they had gone out of their way to support patients.

Responsive

No action required

Updated 14 May 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. Opening hours were good and the practiced opened on Saturdays to meet patient demand.

Staff considered patients’ different needs which included providing facilities for patients with disabilities.

The practice took patients’ views seriously. They valued compliments from patients and responded to concerns and complaints quickly, empathetically and professionally

Well-led

No action required

Updated 14 May 2019

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

There was an overarching governance framework which supported the delivery of good quality care. There was a clearly defined management structure and staff felt supported and valued in their work. Communication systems were effective with daily meetings and regular practice meetings.

The practice 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. We found staff had an open approach to their work and shared a commitment to continually improving the service they provided.