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Inspection Summary


Overall summary & rating

Updated 9 March 2017

We carried out an announced comprehensive inspection on 19 January 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

Jersey Farm Dental Practice is a general dental practice situated in the Hertfordshire town of St Albans.

The practice has three dental treatment rooms and offers general dentistry to adults and children funded by the NHS or privately.

The practice has two dentists, two dental hygienists, three dental nurses and two receptionists. The premises are situated on the first floor of a development within a commercial courtyard, with use of a central car park.

The practice is open between 8 am and 5 pm on Monday to Thursday and 8 am to 4 pm on a Friday.

The practice owner is registered with the Care Quality Commission (CQC) as an individual. 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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience. We received feedback from 35 patients. These provided a positive view of the services the practice provides. Patients commented on the quality of care, the polite and friendly nature of staff and the cleanliness of the practice.

Our key findings were:

  • The practice was visibly clean and clutter free.

  • Comments from patients indicated that the staff were kind and caring and were skilled at putting nervous patients at ease.

  • At the time of the inspection the practice was accepting new patients. Children could be offered appointments funded by the NHS, adults were privately funded.

  • The practice had policies in place to assist in the smooth running of the service.

  • The practice used national guidance in the care and treatment of patients.

  • The practice met the national guidance in decontamination of dental instruments.

  • Risk assessments were in place to identify, monitor and mitigate risks arising from carrying out the regulated activities.

  • Clinical audit was used as a tool to highlight areas where improvements could be made.

  • Patients commented that options for treatment were explained to them in detail and this was in evidence in the dental care records we were shown.

  • Staff demonstrated good knowledge and procedures in the process of consent, although not all staff had a clear understanding of the situations when a child can consent for themselves.

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

  • Review arrangements for monitoring the availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

  • Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities.
Inspection areas

Safe

No action required

Updated 9 March 2017

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

The practice had medicines and equipment to manage medical emergencies, although some sizes of oropharyngeal airway were missing. Certain equipment also seemed old or dusty. Missing or old emergency equipment was replaced following the inspection.

The practice was carrying out appropriate pre-employment checks on staff to ensure they employed fit and proper persons.

Equipment had been serviced and tested in line with manufacturers’ instructions and national guidance.

Effective

No action required

Updated 9 March 2017

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

The dentists used nationally recognised guidance in the care and treatment of patients.

A comprehensive screening of patients was carried out at check-up appointments, and included screening for gum disease.

The practice demonstrated good knowledge and systems in the process of consent, and this was evidenced by the dental care records. In discussions around children giving consent it was clear that although the principle was understood some staff were less clear on how to apply this in practice.

Caring

No action required

Updated 9 March 2017

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

Comments from patients were overwhelmingly positive about the care and treatment they received.

Patients were involved in the decisions around their treatment and care.

Written treatment plans were given to patients for them to be able to consider their options.

Responsive

No action required

Updated 9 March 2017

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

The practice endeavored to see all emergency patients on the day they contacted the practice.

The practice were aware of their limitations in accessibility due to being on the first floor, however took what steps they could to ensure the premises were as accessible as possible.

Interpreters could be arranged for patients that did not speak English as a first language.

Well-led

No action required

Updated 9 March 2017

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

Polices were available to assist in the smooth running of the service. These had all been reviewed in the year before our visit.

The practice used clinical audit as a tool to highlight areas where improvements could be made.

Staff had annual appraisals where their training needs were addressed and a personal development plan drawn up to reflect it.