Greyholme Dental Suite

We carried out this announced inspection on 18 February 2020 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 Care Quality Commission, (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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

We found this practice was providing responsive 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

Greyholme Dental Suite is in Bishops Cleve near Cheltenham and provides private dental care and treatment for adults and children.

Patients will need to use stairs to access the first floor of this practice. There are some short stay car parking spaces near the practice.

The dental team includes one dentist, two dental nurses, three dental hygienists, one receptionist and a practice manager. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 14 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with the prinicipal dentist, two dental nurses, one dental hygienist, one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday and Tuesday 8am – 7:30pm
• Wednesday 8am – 4:30pm
• Thursday closed
• Friday 9am - 2pm
• Saturdays by prior arrangement only

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements.
• The provider had effective leadership and a culture of continuous improvement. Although, this should be improved by implementing dental care record and antibiotic prescribing audits.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. Although, some equipment and a medicine should be reviewed to ensure it met with guidelines.
• The provider had systems to help them manage risk to patients and staff. Some improvemetns should be made to how the practice managed fire safety and risk assessed substances hazardous to health.
• The provider’s recruitment procedures did not reflect current legislation requirements.

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

• Implement an effective recruitment procedure to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.
• Improve the practice's processes for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken.
• Take action to implement any recommendations in the practice's fire safety risk assessment and ensure ongoing fire safety management is effective.
• Take action to ensure the availability of British Sign Language and an interpreter service for patients who do not speak English as their first language.
• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.