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Broadway Dental Care - Cotswold Dental Limited

Inspection Summary


Overall summary & rating

Updated 31 October 2016

We carried out an announced comprehensive inspection on 26 September 2016 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

Broadway Dental Care is situated in the Cotswold village of Broadway, Worcestershire and provides private dental treatment for all age groups. It has been operated by the same dentist since 1998, initially as a sole trader and then from 2007 as Cotswold Dental Limited, a limited company. The company secretary is the practice manager and a dental nurse. They are also 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 practice has one dentist (the Company Director) and three other dental nurses. The registered manager and clinical team are supported by a receptionist.

The practice has one dental treatment room and a separate decontamination room for the cleaning, sterilising and packing of dental instruments. The waiting room is separate from the reception area which helps provide privacy when staff are dealing with patients at the reception desk or on the telephone.

The practice is on the first floor of the building and there is no lift. The practice had carried out an assessment as required under the Disability Discrimination Act. Through this they identified that apart from fitting robust handrails there are no other changes they can make to the structure of the building to improve access for patients unable to climb stairs. They have explored the possibility of moving to different premises but none suitable are available in the village. The practice assists patients unable to use stairs to find or move to practices with suitable access.

The practice is open from 9am to 5pm Monday to Friday except Wednesdays when the practice opens by special arrangement. The practice is closed for lunch from 1pm to 2pm.

Before the inspection we sent Care Quality Commission comment cards to the practice so patients could give us their views about Broadway Dental Care. We collected 48 completed cards and spoke with two patients at the practice. The information provided showed that the practice was highly regarded by patients who were very complimentary about the dentist and the other members of the practice team. They described receiving gentle, thorough care and being treated with kindness and respect by staff. A large proportion commented on how well the dentist explains treatment to help them make decisions about their care. More than a third of patients specifically mentioned that cleanliness and hygiene at the practice was very good with several saying this was exemplary.

Our key findings were:

  • The practice was visibly clean and feedback from patients confirmed this was always the case. National guidance for cleaning, sterilising and storing dental instruments was followed.
  • The practice had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.
  • The practice had clear processes for dealing with medical emergencies and for maintaining the equipment used at the practice.

  • Dental care records provided clear information about patients’ care and treatment and patients received written treatment plans.
  • Staff received training appropriate to their roles and were supported to meet the continuous professional requirements of the General Dental Council.

  • Patients were able to make routine and emergency appointments when needed.

  • The practice used in-house patient surveys, to enable patients to give their views about the practice. Staff had opportunities to contribute their views through daily discussions, regular staff meetings and annual appraisals.

  • Patients’ comments showed they held the practice in high regard; they were complimentary about the practice team and all aspects of the care and treatment they received.

  • The practice had comprehensive governance processes to help them manage the service and continued to review and develop these with the aim of ongoing improvement.

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

  • Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
  • Review the availability of an interpreting service for patients who do not speak English as their first language or who use British Sign Language.
  • Review progress in obtaining a hearing loop to assist those who use hearing aids.
  • Review the practice's recruitment procedures so they provide more specific guidance regarding information required for staff being recruited.
  • Review the options available for the registered manager to receive annual appraisals.
Inspection areas

Safe

No action required

Updated 31 October 2016

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

The practice was committed to providing a safe service and had well organised systems to ensure care and treatment was carried out safely. This included processes to discuss and make improvements when things went wrong.

There were policies, risk assessments and well organised arrangements for important aspects of health and safety. These included infection prevention and control, clinical waste management, dealing with medical emergencies, dental radiography (X-rays) and fire safety. Maintenance of equipment was well organised. The staff recruitment policy needed to provide additional about the information needed for new staff.

Staff were aware of their responsibilities for safeguarding adults and children. The practice had safeguarding policies and procedures and contact information for local safeguarding professionals was readily available for staff to refer to if needed.

Effective

No action required

Updated 31 October 2016

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

The practice assessed patients’ and care and treatment in a personalised way taking into account current legislation, standards and evidence based guidance. They provided patients with written treatment plans and patient feedback confirmed that their care was discussed with them clearly and thoroughly. Referrals to other dental or NHS services were made in line with relevant guidance when this was necessary and the practice worked in partnership with other health professionals.

Clinical staff were registered with the General Dental Council and completed continuous professional development to meet the requirements of their professional registration

Staff understood the importance of obtaining informed consent and used written consent forms. The practice team were aware of the importance of taking the Mental Capacity Act 2005 into account when considering whether patients were able to make their own decisions but needed to develop this further.

Caring

No action required

Updated 31 October 2016

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

The patient feedback we reviewed was unanimously positive and showed that the practice was highly regarded by patients.

Patients described the dentist and the other members of the practice team as professional, skillful, courteous and caring. The practice was aware of the importance of confidentiality and this was covered in staff training. Staff spoke about patients respectfully and during the inspection we saw they were welcoming and helpful. Patient feedback confirmed that the dentist explained their treatment clearly and involved them in decisions about their dental care.

Responsive

No action required

Updated 31 October 2016

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

The patient feedback we reviewed showed high levels of satisfaction with the practice and confirmed that patients received a personalised service that met their needs.

The practice was on the first floor of the building and there was no lift so was not suitable for patients unable to climb stairs. The practice had carried out an assessment as required under the Disability Discrimination Act. This identified that apart from fitting robust handrails on the staircase there were no other changes they could make to the structure of the building to improve access for patients unable to climb stairs. They had explored the possibility of moving to different premises but nowhere suitable was available in the village. The practice assisted patients unable to use stairs to find or move to practices with suitable access. The practice did not have a hearing loop to assist patients who used hearing aids or details of interpreter services.

The practice had out of hours arrangements so patients could obtain urgent as well as routine treatment when they needed.

The practice had a complaints procedure and responded to complaints promptly and constructively. Information about this and a wide range of other topics was available in the practice information pack and on their website.

Well-led

No action required

Updated 31 October 2016

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

The practice had established governance arrangements to help them ensure that that the practice was well organised and effectively managed. The practice team worked together well. Staff told us they were well supported by the dentist and registered manager. The practice had structured arrangements for managing and monitoring the quality of the service including audits of clinical and non-clinical aspects of the service. There were relevant policies and processes available to all staff.

Dental nurses and reception staff received annual appraisal and were supported and encouraged to take up training opportunities. The dentist was committed to developing their own knowledge and expertise. They were undertaking a master’s degree and were actively involved in dental education as a lecturer.

The practice took the views of patients seriously and used patient surveys to give them feedback. A variety of informal communication and structured staff meetings took place for the practice team to meet and discuss the management of the practice and the care and treatment provided.