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Inspection Summary


Overall summary & rating

Updated 4 April 2017

We carried out an announced comprehensive inspection on 6 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

Cromwell Dental Practice operates from a converted commercial property and provides a mix of private and NHS dentistry. The practice is situated in the town Walton On Thames, Surrey. The practice has two dental treatment rooms; decontamination of dental instruments is mainly carried out within a designated area of each treatment room with another autoclave housed in a designated space in the kitchen area.

The practice staff consists of a dentist, a receptionist and a dental nurse. The practice also employs two part-time dental hygienists.

The practice opens:

Monday to Friday between 9.00am and 5.30pm.

The practice owner is 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.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Before the inspection we sent Care Quality Commission (CQC) comments cards to the practice for patients to complete to tell us about their experience of the practice. We collected 19 completed cards. All the comments from patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

  • We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
  • 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).
  • There were systems in place to reduce and minimise the risk and spread of infection. We did note there were areas that could be improved; these are detailed in the main body of the report.
  • The practice had safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
  • There was a system in place for reporting incidents.
  • Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
  • Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
  • The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
  • The practice maintained a clinical governance system to underpin the clinical care provided.

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

  • Review the practice’s risk assessments and ensure sharps handling procedures and protocols are in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
  • Consider providing an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance is prepared.

  • Consider providing the hygienist with the support of an appropriately trained member of the dental team.
  • Review the availability of hearing loops for patients who are hard of hearing.
  • Consider implementing a system to account for NHS prescriptions issued by the dentist to prevent inappropriate prescribing or loss of prescriptions.
  • Review the practice's protocols for completion of dental records taking into account the guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
Inspection areas

Safe

No action required

Updated 4 April 2017

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

The practice had effective arrangements for essential areas such as clinical waste control, management of medical emergencies at the practice and dental radiography (X-rays). We did find that there were some minor areas that could be improved with respect to infection control protocols and procedures. These are detailed in the main body of the report.

The practice took its responsibilities for patient safety seriously and staff were aware of the importance of identifying, investigating and learning from patient safety incidents.

Staff were aware of their responsibilities regarding safeguarding children and vulnerable adults.

Effective

No action required

Updated 4 April 2017

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

The dental care provided was evidence based and focused on the needs of the patients. The practice used current national professional guidance including that from the National Institute for Health and Care Excellence (NICE) to guide their practice.

We saw examples of positive teamwork within the practice and evidence of good communication with other dental professionals. The staff received professional training and development appropriate to their roles and learning needs.

Staff, where appropriate were registered with the General Dental Council (GDC) and were meeting the requirements of their professional registration.

Caring

No action required

Updated 4 April 2017

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

We collected 19 completed Care Quality Commission patient comment cards. These provided a positive view of the service the practice provided. All the patients commented that the quality of care was very good. Patients commented on friendliness and helpfulness of the staff and dentists were good at explaining the treatment that was proposed.

Responsive

No action required

Updated 4 April 2017

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

Patients were able to access treatment within a reasonable time frame and had adequate time scheduled with the dentist to assess their needs and receive treatment. The practice treated everybody equally and welcomed patients from a range of different backgrounds, cultures and religions.

The practice had a complaints procedure that explained to patients the process to follow. The practice followed the correct processes to resolve any complaints.

Well-led

No action required

Updated 4 April 2017

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

Clinical leadership was provided by practice owner. The staff had an open approach to their work and shared a commitment to continually improving the service they provided.

There was a no blame culture in the practice. The practice had clinical governance and risk management structures in place.

We saw evidence of systems to identify staff learning needs which were underpinned by an appraisal system and a programme of clinical audit. Staff were supported to maintain their continuing professional development as required by the GDC.

Staff told us that they felt well supported and could raise any concerns with the practice owner. All the staff we met said that they were happy in their work and the practice was a good place to work.