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The Fencepiece Dental Practice

Inspection Summary


Overall summary & rating

Updated 14 June 2019

We carried out this announced inspection on 4 June 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a Care Quality Commission (CQC) inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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 Fencepiece Dental Practice is in Ilford in the London Borough of Redbridge. The practice provides private dental treatment to patients of all ages.

The practice is located on the ground floor in purpose-adapted premises. The practice has two treatment rooms, one of which was in use at the time of our inspection. There is step-free access to the practice via a portable ramp. The practice is located close to public transport services.

The dental team includes the principal dentist who owns the practice and two dental nurses. The clinical team are supported by two receptionists who also carry out practice management.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of our inspection we received feedback from 40 patients including 25 people who made comments using the ‘Share Your Experience’ facility on the CQC website.

During the inspection we spoke with the principal dentist, one dental nurse and the two receptionists. We checked practice policies and procedures and other records about how the service is managed.

The practice is open:

Mondays, Wednesdays and Thursdays between 8.45am and 4.45pm

Tuesdays between 8.45am and 7.15pm

Fridays between 8.45am and 3.45pm

The practice is closed each day between 1.30pm and 2.30pm for lunch.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The practice had infection control procedures in place.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The practice had systems to help them manage risk.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had thorough staff recruitment procedures.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The practice was providing preventive care and supporting patients to ensure better oral health.
  • The appointment system met patients’ needs.
  • The practice had effective leadership.
  • Staff felt involved and supported and worked well as a team.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice had arrangements to deal with complaints positively and efficiently.
  • The practice had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

  • Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping. This relates specifically to recording information in relation to the discussions with patients about promoting oral health.
  • Review the practice’s protocols for the use of dental dam for root canal treatment taking into account guidelines issued by the British Endodontic Society. This relates to recording use and in instances where the dental dam is not used, and where other methods were used to protect the airway, this is suitably documented in the dental care record and a risk assessment completed.
Inspection areas

Safe

No action required

Updated 14 June 2019

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

The practice had systems and processes to provide safe care and treatment.

There were systems to use learning from incidents and complaints to help them improve.

Staff received training in safeguarding and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed essential recruitment checks.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had arrangements for dealing with medical and other emergencies.

Effective

No action required

Updated 14 June 2019

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

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance.

Patients described the treatment they received as excellent, very good and perfect. They told us that they were always happy with the care and treatment that they received.

The dentists discussed treatment with patients so they could give informed consent and recorded this in their records.

The practice had arrangements when patients needed to be referred to other dental or health care professionals. There were systems to ensure that referrals were monitored suitably.

The practice supported staff to complete training relevant to their roles and had systems to help them monitor this.

Caring

No action required

Updated 14 June 2019

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

the relevant regulations.

We received feedback about the practice from 40 people. Patients were positive about all aspects of the service the practice provided. They told us staff were

reassuring, helpful and friendly. We were told that staff treated patients with care and respect.

They said that they were given detailed explanations about dental treatment, and said the dentist listened to them. Patients commented that all members of staff made them feel at ease, especially when they were anxious about visiting the dentist.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

The practice had arrangements to obtain the views of patients and used these to improve where indicated the level of patient satisfaction.

Responsive

No action required

Updated 14 June 2019

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

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if they were experiencing dental pain.

Staff considered and took into account patients’ different needs and had made reasonable adjustments to accommodate patients who may need additional support.

The practice could make arrangements to help patients with sight or hearing impairment and those whose first language was not English.

The practice took patients views seriously. They valued compliments from patients and had arrangements to respond to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 14 June 2019

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

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided. There was a clearly defined management structure and staff felt supported and appreciated.

The practice had a range of policies and procedures to underpin the day to day management of the service.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.

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

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided. There was a clearly defined management structure and staff felt supported and appreciated.

The practice had a range of policies and procedures to underpin the day to day management of the service.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.