Archived: Lime Tree Dental Practice

Updated 30 March 2017

This inspection took place on 19 January 2017. The focused inspection was led by a CQC inspector who had access to remote advice from a dental specialist advisor.

We conducted a tour of the practice and looked at the decontamination and governance processes as the practice had been non-compliant in these areas at the last inspection. During our inspection visit, we reviewed policy documents, staff records. We spoke with three patients, five members of staff and the practice manager.

We observed the dental nurses carrying out decontamination procedures of dental instruments and also observed staff interacting with patients in the waiting area. Patients gave positive feedback about their experience at the practice.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 30 March 2017

We carried out an announced responsive follow up inspection on 19 January 2017 to ask the practice the following key questions; Are services safe and are they well-led?

We had undertaken an announced comprehensive inspection of this service on 26 April 2016 as part of our regulatory functions where breaches of legal requirements were found.

Our findings were:

Are services safe?

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

Are services well-led?

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

Background

Lime Tree Dental Practice is a wholly private practice offering a family service with a breadth of dentistry and a membership payment scheme. It is a detached suburban property situated near the centre of Portishead with roadside parking. The practice has a ramp to the front door to enable access for patients with mobility needs, a ground floor reception and surgery facilities. There is a patient toilet on the ground floor but due to building constraints it is not accessible to wheelchair users.

There are two waiting rooms, two treatment rooms, one on the ground floor and one on the first floor.

The practice has a team of five dentists with a variety of expertise and patients may see different dentists for different parts of their treatment.

The practice has a principal dentist / provider who is registered as an individual provider. A registered provider is a ‘registered person’ who is registered with the Care Quality Commission to run the service. Registered persons 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 practice is open Monday, Tuesday and Friday 8.30am to 5.00pm; Wednesday 8.30am to 2.00pm offering lunchtime appointments; Thursday 8.30am to 7.00pm; Friday 8.30am to 5.00pm. Some Saturday appointments were offered according to patient need. For emergency and out of hour’s assistance contact information is available from the practice telephone answering service.

We reviewed 56 CQC comment cards that had been left for patients to complete, prior to our visit, about the services provided. In addition we spoke with seven patients on the day of our inspection. Feedback from patients was positive about the care they received from the practice. They commented staff put them at ease, listened to their concerns and provided an excellent service in which they had confidence in the dental care provided.

Our key findings were:

• The patients we spoke with indicated they were treated with kindness and respect by staff and received good care in a clean environment from a helpful practice team. We observed good communication with patients and their families.
• Premises appeared well maintained and visibly clean. Good cleaning and infection control systems were in place. The treatment rooms were well organised and equipped, with good light and ventilation
• The practice was meeting the Essential Quality Requirements of the Department of Health guidance, namely 'Health Technical Memorandum 01-05 - Decontamination in primary care dental practices (HTM 01-05)' national guidance for infection prevention control in dental practices.
• The dental practice had effective clinical governance and risk management processes in place; including health and safety and the management of medical emergencies. There were systems in place to learn and improve from incidents or healthcare alerts.
• The practice had a comprehensive system to monitor and continually improve the quality of the service; including through a detailed programme of clinical and non-clinical audits.
• There were systems in place to check all equipment had been serviced regularly, including the air compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.
• Appropriate recruitment processes and checks were undertaken in line with the relevant recruitment regulations and guidance for the protection of patients.
• There were sufficient numbers of suitably qualified staff who maintained the necessary skills and competence to support the needs of patients.
• Staff were supported to maintain their continuing professional development; had undertaken training appropriate to their roles and felt supported in their work.
• The practice had an empowered practice manager who provided accessible and visible leadership and clear means of sharing information with staff. Staff were up to date with current guidelines and supported in their professional development.