Archived: Rush Hill Dental Centre

Updated 12 November 2015

We carried out a comprehensive inspection at Rush Hill Dental Centre on 4 August 2015 as part of our inspection programme. The inspection was carried out by a Care Quality Commission inspector and a dental specialist advisor. The inspection included the review of records, policies and procedures. In addition we spoke with six staff (including dentists; dental nurses; practice managers and receptionists) and three patients. To assess the quality of care provided we looked at practice policies and protocols and other records relating to the management of the service. We observed how patients were dealt with and how the nurses undertook decontamination of dental instruments.

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 12 November 2015

We carried out an announced comprehensive inspection on 4 August 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

The practice is part of the Whitecross Dental Care Ltd, IDH (Integrated Dental Holding Ltd) Dental Group which is the largest dental corporation in Europe employing over 2,500 dental professionals. IDH Rush Hill provides general dental treatments for people who live in Bath and the surrounding areas. Three dentists provide services supported by two dental nurses and there are two treatment rooms. The practice predominantly provides treatment for patients who have NHS subsidy (95%) and approximately 5% pay for treatment privately.

The practice is open on weekdays between the hours of 8.30 am and 5 pm and Saturday mornings. The practice employed three dentists. Details about the arrangements for emergency treatments out of hours was in a recorded message played on the telephone answering service when the practice was closed.

The practice is located in a purpose built general practice medical centre over two floors with patient access on the ground floor. The building was compliant with the Disability Discrimination Act (DDA) 1995. There is disabled access and disabled parking.

The practice manager was in the process of registering as the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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 spoke with three patients who visited the practice and we reviewed 32 patient comment cards from our Care Quality Commission (CQC) comments box that had been placed in the practice prior to our inspection. Patients told us the practice was clean and hygienic; staff were motivated and caring whilst treating them with dignity and respect.

Our key findings were:

• There were systems in place for staff to report incidents. There were sufficient staff on duty to deliver the service. We saw the premises were in a satisfactory state of repair and was clean and tidy.
• The patients we spoke with and the comment cards we reviewed indicated patients were treated with kindness and respect by staff. It was reported that communication with patients and their families, and access to the service and to the dentists was good.
• Staff received training appropriate to their roles.
• Information on the practice website was incorrect with regards to opening times, treatments provided and dentists working at the practice.
• Information about care and treatment options and support was available to patients, for example information of the cost of treatment.
• The practice had a complaint system in place and these were dealt with in an open and transparent way. However we found evidence some complaints had not been logged onto the complaints system.
• We found that cleaning staff did not complete a daily checklist to evidence what cleaning had taken place and no cleaning schedule had been devised.
• We saw no evidence that equipment had undergone testing or calibration to control risks arising from the use of electricity.
• We found dental care records lacked details about how consent was obtained.
• We found inconsistent use of equipment, grading and recording with regards to the use of X-rays.
• We found recruitment files did not always contain the same information and one record did not have an appropriate criminal records check.

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

• Consider having a stock of equipment required to undertake dental procedures.
• Consider the use of national guidelines. For example, for recording, grading and justification of X-rays and for equipment to support invasive treatments.

• Keep an accurate, accessible system for recording and handling of complaints.
• Consider the frequency of testing for electrical equipment and keep adequate records of safety checks of equipment.
• Maintain adequate individual recruitment and staff folders.
• Maintain accurate, complete and contemporaneous dental care records.
• Ensure a system is in place to provide and maintain a clean environment through documentation of environmental cleaning to show consistent undertaking, reporting and monitoring.

Ensure there is provision of adequate cleaning equipment which is stored safely.