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Inspection Summary


Overall summary & rating

Updated 12 August 2016

We carried out an announced comprehensive inspection on 18 July 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

TLC Dental located in Newham provides NHS and private dental treatment to patients of all ages.

Practice staffing consists of the principal dentist, four associate dentists, one oral surgeon, one dental therapist, two receptionists and the practice manager.

The principal dentist is registered with the Care Quality Commission (CQC) as an individualregistered persons. 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 to Friday 9.00am to 5.00pm

The practice facilities include four treatment rooms, reception area, two waiting areas, two decontamination rooms, one office and a staff room/kitchen.

We reviewed 21 CQC comment cards, the practice patient satisfaction survey and the NHS Friends and Family test comment cards. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

Our key findings were:

  • Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
  • We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
  • Patients were involved in their care and treatment planning so they could make informed decisions.
  • There were effective processes in place to reduce and minimise the risk and spread of infection.
  • Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
  • Equipment, such as the autoclaves, fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
  • Patients were treated with dignity and respect and confidentiality was maintained.

  • The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
  • Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice.
  • Patients had good access to appointments, including emergency appointments, which were available on the same day
  • The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.
  • The practice had not ensured that appropriate medicines, in line with British National Formulary and Resuscitation Council (UK) guidance, were available to respond to a medical emergency.

There were areas where the provider could make improvements and should:

  • Review availability of medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
  • Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
Inspection areas

Safe

No action required

Updated 12 August 2016

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

The practice had systems in place for identifying, investigating and learning from incidents relating to the safety of patients. The infection prevention and control practices at the surgery followed current national guidance. All equipment at the practice was regularly maintained, tested and monitored for safety and effectiveness.

Patients were protected against the risks of abuse or harm through the practice policies and procedures. Staff were trained to recognise and report concerns about patients’ safety and welfare and had access to contact details for the local safeguarding team.

There were procedures in place for recruiting new staff and these were followed consistently. All of the appropriate checks including employment references, proof of identification and security checks were carried out when new staff were employed. The staff were suitably trained and skilled to meet patient’s needs and there were sufficient numbers of staff available at all times.

The practice had undertaken a risk assessment in relation to the Control of Substances Hazardous to Health 2002 (COSHH) regulations.

Effective

No action required

Updated 12 August 2016

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

The practice provided evidence-based care in accordance with relevant, published guidance, for example, from the Faculty of General Dental Practice (FGDP), National Institute for Health and Care Excellence (NICE) Department of Health (DH) and the General Dental Council (GDC). Health education for patients was provided by the dentists and therapists; information leaflets were available within the practice. They provided patients with advice to improve and maintain good oral health

The practice ensured that patients were given sufficient information about their proposed treatment to enable them to give informed consent.

The staff kept their training up-to-date and received professional development appropriate to their role and learning needs. Staff who were registered with the General Dental Council (GDC) demonstrated that they were supported by the practice in continuing their professional development (CPD) and were meeting the requirements of their professional registration.

Caring

No action required

Updated 12 August 2016

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

We reviewed 21 CQC comment cards, the practice patient satisfaction survey and the NHS Friends and Family Test comment cards. Patients were positive about the care they received from the practice. Patients commented they felt fully involved in making decisions about their treatment, they were listened to, were made comfortable and reassured.

Patients were complimentary about the practice and how the staff treated them. Patients commented positively on how caring and helpful staff were, describing them as friendly, compassionate and professional.

Staff had a good awareness of how to support patients who may lack capacity to make decisions about their dental care and treatment.

Responsive

No action required

Updated 12 August 2016

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

There were systems in place for patients to make a complaint about the service if required. The practice reviewed patient’s comments and acted on them where necessary. Patient’s comments from the practice patient satisfaction survey were reviewed on a regular basis. Information about how to make a complaint was readily available to patients. Patients had access to information about the service.

The practice provided friendly and personalised dental care. Patients had good access to appointments, including emergency appointments, which were available on the same day. In the event of a dental emergency outside of normal opening hours patients were directed to ‘111’ out of hours service and the contact details were available for patients’ reference.

Well-led

No action required

Updated 12 August 2016

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

There was a pro-active approach to identifying safety issues and make improvements in procedures. There was candour, openness, honesty and transparency amongst all staff we spoke with.

Patients’ views were regularly sought by way of a patient survey and these were acted upon as required. Staff commented that the principal dentist and practice manager were open to feedback regarding the quality of the care.

The practice had suitable clinical governance and risk management structures in place. Staff told us they enjoyed working at the practice and felt part of a team. Opportunities existed for staff for their professional development. Staff we spoke with were confident in their work and felt well-supported.