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Inspection Summary


Overall summary & rating

Updated 10 December 2015

We carried out an announced comprehensive inspection on 3 November 2015 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

Mackworth Dental practice was registered with the Care Quality Commission (CQC) in June 2011 to provide dental services to patients in the city of Derby and the surrounding areas. The practice provides both NHS and private dental treatment, with approximately 95% being NHS patients. Services provided include general dentistry, dental hygiene, teeth whitening, crowns and bridges, and root canal treatment.

The practice is open Monday to Friday from 8:30 am to 5:30 pm. Access for urgent treatment outside of opening hours is usually through the NHS 111 telephone line.

The practice has two dentists; one hygienist/ therapist; four dental nurses; and one practice manager. Dental nurses also work on reception.

The practice did not have a registered manager at the time of our inspection. The practice manager was in the process of applying to be the registered manager.  A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered 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.

We received feedback from 20 patients about the services provided. We saw that feedback was wholly positive. Patients said they were very satisfied with the service provided, and spoke positively about their experience at this dental practice. Patients said they were treated well, and that staff were friendly and approachable. Patients were able to ask questions, and the dentist explained the treatment options and costs.

Our key findings were:

  • The practice formally recorded accidents, significant events and complaints.
  • Learning from any complaints and significant incidents were recorded and learning was shared with staff.
  • All staff had received whistle blowing training and were aware of these procedures and the actions required.
  • Patients provided positive feedback about the dental service.
  • Patients said they were treated with dignity and respect.
  • Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Staff had been trained to deal with medical emergencies.
  • Emergency medicines, an automated external defibrillator (AED) and oxygen were readily available. An AED is a portable electronic device that automatically diagnoses life threatening irregularities of the heart and delivers an electrical shock to attempt to restore a normal heart rhythm.
  • The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
  • Patients’ care and treatment was planned and delivered in line with National Institute for Health and Care Excellence (NICE) guidelines.
  • Not all of the policies and procedures in use at the practice had been reviewed.
  • Patients were involved in making decisions about their treatment
  • Patients’ notes did not always reflect the reason for and clarity of X-rays taken at the practice.
  • Options for treatment were identified and explored and discussed with patients.
  • Patients’ confidentiality was maintained.

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

  • Display the instructions for the use of sharps bins beside any sharps bin as detailed in Health and Safety (sharp instruments in healthcare) Regulations 2013.
  • Review the clinical notes for patients’ who have had radiographs to ensure that X-rays were graded, the views taken were recorded, and the justification for taking the X-ray and the clinical findings were clear.
  • Review all policies and procedures at the practice to ensure staff have the latest and most up-to-date information and guidance.
Inspection areas

Safe

No action required

Updated 10 December 2015

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

The practice had systems to record accidents and significant events and learning points were shared with staff in team meetings.

The practice received Medicines and Healthcare products Regulatory Agency (MHRA) alerts and took appropriate action including sharing information with staff.

Staff had been trained in safeguarding vulnerable adults and children. There were clear guidelines for reporting concerns and the practice had a lead member of staff to offer support and guidance over safeguarding matters. However, the safeguarding vulnerable adults and children policy was in need of review.

The practice had the necessary emergency equipment including an automated external defibrillator (AED) and oxygen.

Recruitment checks were completed on new members of staff. This was to ensure staff were suitable and appropriately qualified and experienced to carry out their role.

Infection control procedures followed published Department of Health guidance to ensure that patients were protected from potential risks.

Equipment used in the decontamination process was maintained by a reputable company and regular frequent checks were carried out to ensure equipment was working properly and safely.

X-rays were carried out safely in line with published guidance, and X-ray equipment was regularly serviced to make sure it was safe for use. However, patients’ notes did not always reflect the reason for taking the X-rays and the clinical findings were not always clear.

Effective

No action required

Updated 10 December 2015

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

Patients were clinically assessed before any treatment began. This included completing a health questionnaire or updating one for returning patients who had previously completed a health questionnaire.

The practice was following National Institute for Health and Care Excellence (NICE) guidelines for the care and treatment of dental patients. Particularly in respect of recalls, wisdom tooth removal and the use of antibiotics.

Dentists discussed the risk factors that could affect their oral health with patients.

The practice had sufficient numbers of qualified and experienced staff to meet patients’ needs.

There were clear procedures for referring patients to secondary care (hospital or other dental professionals).

Caring

No action required

Updated 10 December 2015

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

Staff protected patients’ confidentiality.

Patients were treated with dignity and respect.

Staff were open and welcoming to patients at the dental practice.

Patients said they received good dental treatment and they were involved in discussions about their dental care.

Patients said they were able to express their views and opinions.

Responsive

No action required

Updated 10 December 2015

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

The practice appointments system met patients’ needs. Patients who were in pain or in need of urgent treatment were usually seen the same day.

The practice could meet the needs of patients with restricted mobility, with level access, and a ground floor treatment room.

There were arrangements for emergency dental treatment outside of normal working hours, including weekends and public holidays which were clearly displayed in the waiting room, and on the practice website.

Well-led

No action required

Updated 10 December 2015

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

The practice was carrying out audits of both clinical and non-clinical areas to assess the safety and effectiveness of the services provided.

There was an annual programme of audits and review to follow.

Patients were able to express their views and comments in a variety of different ways, both in the practice and through the website.

Staff said the practice was a friendly place to work, and they could speak with the practice manager or a dentist if they had any concerns.

Not all policies and procedures at the practice had been reviewed or were up-to-date.