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Inspection report

Date of Inspection: 18 August 2014
Date of Publication: 9 September 2014
Inspection Report published 09 September 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 18 August 2014, observed how people were being cared for and talked with people who use the service. We talked with staff and reviewed information given to us by the provider.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

Patients’ needs were assessed and care and treatment was planned and delivered in line with their individual treatment plan. During our visit the dentist explained the information recorded at each patient's initial examination and at subsequent visits. They recorded their examinations of soft tissues and teeth and other relevant observations. We saw that patient records contained a record of the examination and the findings. The dentist had recorded information received from the patient such as, their medical and social history, smoking status and the date of their last dental visit. This information was used in the assessment of each patient’s oral health. New patients were also given an oral health questionnaire to complete. This meant that the dentist was aware of all factors which may influence the treatment or advice they offered. We spoke with four patients who were all aware of the checks the dentist had made at their examination. One patient said; “[The dentist] always checks my whole mouth, my neck and glands”. Another said; "It is a whole round picture".

Diagnostic tests, such as radiographs (x-rays), were carried out if they were clinically necessary. The justification for any diagnostic tests was clearly recorded in patient records.

The receptionist told us that each patient was asked to provide a medical history and at each subsequent examination they were asked to check if there had been any changes. We saw patients being asked to check their medical history and record any changes. We saw that the written medical history was given to the dentist to review before the patient entered the surgery. This meant that the dentist would be aware of any medical issues which could affect the planning of the patient's treatment. Patients we spoke with confirmed that they were always asked if there was any change to their medication or health.

During our visit we spoke with four patients about their care and treatment. All of the patients we spoke with commented positively on the way the dentist explained their treatment plan and communicated throughout their treatment. All the patients we spoke with praised the caring, understanding attitude of all the staff. They told us they were very satisfied with the standard of treatment provided. One patient told us: “The attitude has made me stay and not worry about coming back”. Another patient described the way in which the dentist was able to help them relax; “I have just had a root canal I could have fallen asleep through”.

Another patient was complimentary about the treatment they received from the practice and the way the practice was able to offer evening and Saturday appointments. They said: “They fit around my work time” and “I am not terrified like I used to be”.

One of the dentists at the practice provided treatment under inhalation sedation (IS). This is a form of sedation, a mixture of nitrous oxide and oxygen breathed through a nosepiece. This helps patients to feel relaxed and accept treatment. We saw that there were procedures in place to ensure that appropriate safety checks were made of equipment before treatment was started. There was an effective system in place to ensure that all pre sedation checks had been carried out such as checks of the equipment, patient’s signed consent had been obtained and that patient health and wellbeing had been assessed. Each patient record contained a copy of the checklist which had been completed for each episode of treatment under IS. A log was kept of throughout the treatment to record all aspects of the sedation process. The dentist who carried out treatment under IS was a member of the British Society of Paediatric Dentistry and The Society for the Advancement of Anaesthesia in Dentistry (SAAD) and along with their dental nurse had completed appropriate SAAD training in the use of IS.

There were arrangements in place to deal with foreseeable emergencies. We saw that the practice had emergency drugs and oxygen available