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Inspection Summary


Overall summary & rating

Updated 29 April 2016

We carried out an announced comprehensive inspection on 31 March 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

Inspired Dental Care is located in Exeter city centre. The practice is situated over two upper floors in a commercial area of the city. There is a passenger lift for access to the practice for patients with limited mobility. There are three treatment rooms, a decontamination room, a ‘Chompers’ Club’ lounge for educating children about good oral health care, a reception with a waiting area and a further patient lounge.

The practice provides private dental services and cosmetic dental services to approximately 1500 patients. The majority of patients are adults.

The staff structure of the practice consists of four dentists (two principle dentists, one periodontal specialist dentist and one sessional sedation dental practitioner). There are two dental hygienists, three dental nurses/receptionists and a practice manager.

The practice is open six days a week from Monday to Saturday. Evening appointments are available on Wednesdays. The practice closes at 3.30pm on Saturdays. There is an answer phone message directing patients to emergency contact numbers when the practice is closed.

The practice manager is the registered manager with the Care Quality Commission (CQC). 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 dental practice manager specialist advisor.

Thirteen patients provided feedback directly to CQC about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly, professional and caring attitude of the dental staff.

Our key findings were:

  • 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 effective systems in place to reduce and minimise the risk and spread of infection.
  • The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.

  • Staff knew how to report incidents and how to record details of these so that the practice could use this information for shared learning.

  • 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.

  • There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

  • 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 had implemented clear procedures for managing comments, concerns or complaints.

  • The provider had a clear vision for the practice and staff told us they were well supported by the management team.

  • Governance arrangements were in place for the smooth running of the practice.

  • Patients with children benefitted from the provision of a dedicated ‘Chompers’ Club’ space, which was child friendly and geared to the education and promotion of good oral health care in children. These education sessions were run by the dentists.

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

  • Provide a thermometer in the decontamination room for ensuring the correct water temperature is maintained when hand washing and rinsing dental instruments.
  • Develop systems for feeding back to patients about action taken as a consequence of surveys, patient suggestions or comments.
Inspection areas

Safe

No action required

Updated 29 April 2016

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

The practice had systems in place to minimise the risks associated with providing dental services. The practice had policies and protocols, which staff were following, for the management of medical emergencies. There were systems in place for identifying, investigating and learning from incidents relating to the safety of patients and staff members. Staff had good awareness of safeguarding issues, which were informed by and supported by practice policies.

We found the equipment used in the practice was checked for effectiveness. Infection control processes were safely managed, however, it was not possible to check the correct water temperature when hand washing dental instruments.

Effective

No action required

Updated 29 April 2016

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

The practice provided evidence-based care in accordance with relevant, published guidance, for example, from the General Dental Council (GDC). The practice monitored patients’ oral health and gave appropriate health promotion advice. Patients with children benefitted from the provision of a dedicated ‘Chompers Club’ space, which was child friendly and geared to the education and promotion of good oral health care in children. Staff explained treatment options to ensure that patients could make informed decisions about any treatment. The practice worked well with other providers and followed up on the outcomes of referrals made to other providers.

Staff engaged in continuous professional development (CPD) and were meeting the training requirements of the General Dental Council (GDC). New staff had received an induction and were engaged in a probationary process to review their performance and understand their training needs.

Caring

No action required

Updated 29 April 2016

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

We received positive feedback from patients through nine written comment cards and by speaking with four patients on the day of the inspection. Patients felt that the staff were kind and caring; they told us that they were treated with dignity and respect at all times. We found that dental care records were stored securely and patient confidentiality was well maintained.

Responsive

No action required

Updated 29 April 2016

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

Patients had good access to appointments, including emergency appointments, which were available on the same day. There was a complaints policy in place. The practice had not received any complaints in the past year. Systems were in place for receiving more general feedback from patients, with a view to improving the quality of the service. This included commenting via the practice website, a comments book in the practice reception area and patient surveys. Systems had not yet been developed to promote a response from the practice to what had been done as a result of patient feedback.

The culture of the practice promoted equality of access for all. The practice staff told us that if patients visited with support dogs, for assistance with a visual or a hearing impairment, that the dogs would be welcomed. The facilities for people with limited mobility were good, with wide corridor spaces and large treatment rooms. There was an accessible toilet and a passenger lift to the practice from the street level entrance.

Well-led

No action required

Updated 29 April 2016

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

The practice had clinical governance and risk-management structures in place. Staff described an open and transparent culture where they were comfortable raising and discussing concerns with the management team (practice manager and two principle dentists). They were confident in the abilities of the managers to address any issues as they arose.