You are here

The Dental and Cosmetic Clinic

Inspection Summary


Overall summary & rating

Updated 18 February 2016

We carried out an announced comprehensive inspection on 16 November 2015 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

The Dental and Cosmetic Clinic is located in the suburbs of Leicester in South Wigston. It is outside the city boundary, forming part of the Oadby and Wigston district of Leicestershire. There are good public transport links within the area and a railway station a short walk away from the clinic. The clinic has ample car parking to the rear of the premises for its patients to use.

The practice provides only private dental services and treats both adults and children. The practice serves a population of approximately 3,000. This includes around 50 children.

There are eight members of staff working within the practice team. This consisted of one dentist, four dental nurses and two dental hygienists. In addition the clinic has a practice manager who is also qualified as a dental nurse. There is a receptionist employed who is supported by the practice manager and one of the dental nurses when the reception desk requires manning.

The practice opening hours are Monday to Friday 9.00am to 5.30pm.

We received feedback from 41 patients. All feedback included extremely positive comments about the practice and the majority made particular reference to the staff. Comments supported that the practice was able to meet the needs of nervous patients and those with special needs including physical and learning difficulties. One person commented that it was the best service a patient could ever have. Remarks were also made regarding the cleanliness of the practice. We did not receive any negative comments about the practice.

Our key findings were:

  • The practice had a system for recording and analysing significant events and complaints and sharing learning with staff.
  • Staff had received safeguarding and whistle blowing training and knew the procedures to follow to raise any concerns.
  • There were sufficient numbers of suitably qualified staff to meet patients’ needs.
  • All but one member of staff we spoke with had been trained to handle emergencies and we found that most of the appropriate equipment and medicines were readily available. However, we found that the practice did not have an AED (defibrillator) in place. An AED is a portable electronic device that analyses life threatening irregularities of the heart and delivers an electrical shock to attempt to restore a normal heart rhythm. When this was raised with the practice manager, they made a decision to purchase an AED there and then. We were provided with assurance following our inspection that the defibrillator had arrived at the practice and was ready for use.
  • Robust infection control procedures were in place and the practice followed national guidance.
  • Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
  • Patients received clear and detailed explanations about their proposed treatment, costs, options and risks. Patients were therefore able to make informed decisions about their choice in treatments.
  • We observed that patients were treated with dignity and respect and confidentiality was maintained.
  • The appointment system met patients’ needs whether they wanted to be seen urgently or for more routine appointments.
  • The practice was well-led and staff worked as a team. There was an open culture in place whereby staff felt able to raise any issues or concerns.
  • Governance systems were effective and there was a range of clinical and non-clinical audits to monitor the quality of services.
Inspection areas

Safe

No action required

Updated 18 February 2016

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

The practice had procedures in place to investigate and respond to significant events and complaints.

The practice had a safeguarding vulnerable adults and children policy and procedures. Staff demonstrated an awareness of the signs of abuse and knew their duty to report any concerns about abuse.

Latex free rubber dams were used when carrying out root canal treatments in line with guidance from the British Endodontic Society.

We saw evidence that medical alerts were flagged to clinicians when treatments took place.

The practice had a whistle blowing policy for staff to raise concerns in confidence. Staff knew the procedure for whistleblowing and who they could speak with about any concerns.

The practice had procedures and equipment for dealing with most medical emergencies. At the time of the inspection the practice did not have an AED (defibrillator) as recommended by the UK resuscitation council. However, during the inspection we observed the practice manager order an appropriate AED with adult and children’s pads and arrange for staff training in its use.

On the day of our inspection, we found staff recruitment procedures required some improvement. Following our discussion with practice management changes to these procedures were immediately implemented and an updated policy and procedure were provided to us after the inspection.

The practice followed national guidance from the Department of Health in respect of infection control.

X-rays were carried out in line with the Ionising Radiation Regulations 1999 (IRR 99) and in line with the Faculty of General Dental Practitioners (FGDP) guidelines.

Effective

No action required

Updated 18 February 2016

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

Patients were assessed at the start of each consultation and updated their medical history. The results of assessments were discussed with patients and treatment options and costs were explained.

Dentists and clinical staff were aware of National Institute for Health and Care Excellence (NICE) guidelines particularly in respect of recalls of patients and anti-biotic prescribing.

Advice was given to patients on how to maintain good oral hygiene and the impact of diet, tobacco and alcohol consumption on oral health.

There were enough suitably qualified and experienced staff to meet patients’ needs. Staff were encouraged to update their training, and maintain their continuing professional development (CPD).

Referrals were made to other services in a timely manner when further treatment or treatment outside the scope of the practice was required.

Staff were aware of the Mental Capacity Act (MCA) 2005, and consent was carried out in line with relevant legislation including the MCA.

Caring

No action required

Updated 18 February 2016

We found that this practice was providing caring services in accordance with

the relevant regulations.

All comments from patients at the practice were extremely positive about the care and treatment they received. Patient’s confidentiality was maintained at all times. Staff treated patients with privacy, dignity and respect.

Patient electronic records were password protected on the computer. However we observed the paper records were stored on open shelving albeit to the side and behind the reception desk. We told the provider that they needed to ensure that this storage area was closed with secure shuttering or the documentation moved to a secure area. We were provided with evidence following our inspection that this area had since been secured.

Responsive

No action required

Updated 18 February 2016

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

The practice provided patients with detailed information about the services they offered on their website and within the practice. The appointment system responded promptly to patients’ routine needs and when they required urgent treatment.

Longer appointment times were available for patients who required extra time or support. Feedback we received from patients supported this.

The practice building was suitable for those who had impaired mobility and the practice had conducted an Equality Act 2010 audit to ensure access for patients who had impairments.

There was a complaints policy and procedure in place. There was assurance regarding the process to be followed in the event of complaints received and how staff learning would be disseminated.

Well-led

No action required

Updated 18 February 2016

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

The practice manager took an active lead in the day to day running of the practice. The practice had arrangements in place for monitoring and improving the services provided for patients. There were governance arrangements in place which were evidenced during our review of documentation held.

The practice had an open and honest culture. We were told that there was a focus at the practice of delivering high quality care and this was evidenced in staff continuous professional development, technological equipment used, and national recognition awards received.

The practice’s philosophy put the patient first, and they were at the heart of everything the practice did. If a patient required urgent treatment out of hours, they could contact their dentist on his personal mobile telephone number. We saw that the dentist reviewed his clinical practice and introduced changes to make improvements.

The comments in the Care Quality Commission (CQC) comment cards we received and the patients we spoke with said that they were delighted with the care and treatment they received. We noted feedback was received from a number of patients who had been registered at the practice for a considerable number of years.

Patients were invited to give feedback at any time they visited the practice as well as through the provider’s website which contained a page dedicated to providing a feedback mechanism.