Archived: 112 Bridge Road Dental Practice

We carried out an announced comprehensive inspection on 9 March 2017 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

Bridge Road Dental Practice is a dental practice providing private treatment for both adults and children. The practice is based in a former domestic dwelling in Locks Heath a town in South Hampshire.

The practice has two dental treatment rooms one of which is based on the ground floor and a separate decontamination area used for cleaning, sterilising and packing dental instruments. The ground floor is accessible to wheelchair users, prams and patients with limited mobility.

The practice employs one dentist, two hygienists and three nurses who also cover reception.

The practice’s opening hours are between 8am and 5.30pm on Monday and Tuesday, 8am and 1pm on Wednesday and Friday and 10am and 7.30pm on Thursday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual and is legally responsible for making sure that the practice meets the requirements relating to safety and quality of care, as specified in the regulations associated with the Health and Social Care Act 2008.

Before the inspection, we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 48 patients. These provided a positive view of the services the practice provides. Patients commented on the high quality of care, the caring nature of all staff, the cleanliness of the practice and the overall high quality of customer care.

We obtained the views of 12 patients on the day of our inspection.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• There was appropriate equipment for staff to undertake their duties, and equipment was generally properly maintained.
• Infection control procedures were and the practice generally followed published guidance.
• The practice had a safeguarding lead with processes in place for safeguarding adults and children living in vulnerable circumstances. We noted that a formal written policy for safeguarding adults needed to be introduced.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice. We noted that a system for receiving national safety alerts needed to be introduced.
• The dentist provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the principal dentist.
• Staff we spoke with felt well supported by the principal dentist and were committed to providing a quality service to their patients.
• Patient feedback before and during our inspection gave us a positive picture of a friendly, caring, professional and high quality service.
• The practice had clinical governance and risk management structures in place, but we observed several shortfalls in systems and processes. Areas for improvement have been detailed in the summary section of the report below.

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

• Review the security of the decontamination room which contained substances subject to COSHH regulations to prevent unauthorised access by the public.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review the use of audits, such as those checking the quality of infection prevention and control measures, to help monitor and improve the quality of service. The practice should also check that where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
• Review the systems that are in place to meet health and safety regulations with respect to fire risk; including reviewing the fire safety risk assessment and fire safety training.
• Review practice's safeguarding policies and staff training and ensure all staff are aware of their responsibilities.
• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting.
• Review the practice’s testing protocols for equipment used for cleaning used dental instruments taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.