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Reports


Inspection carried out on 20 May 2019

During an inspection looking at part of the service

We undertook a focused inspection of Reece Associates LLP on 20 May 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a second CQC inspector.

We undertook a comprehensive inspection of Reece Associates LLP on 30 October 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe or well led care and was in breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Reece Associates LLP on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it safe?

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

Our findings were:

Are services safe?

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

The provider had made improvements in relation to the regulatory breach we found at our inspection on 30 October 2018.

Are services well-led?

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

The provider had made improvements in relation to the regulatory breach we found at our inspection on 30 October 2018.

Background

Reece Associates LLP is in Sutton Coldfield and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available outside the practice but there are no dedicated car parking spaces for patients who are blue badge holders.

The dental team includes four dentists, eight dental nurses (two of whom are trainees), four dental hygienists, one dental hygiene therapist, two practice managers, one decontamination assistant and one receptionist. The dental nurses also carry out reception duties. There is also a visiting sedationist who provides sedation services for patients when needed. The practice has six treatment rooms. There was a separate decontamination room which was due to undergo refurbishment shortly.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Reece Associates LLP is the practice manager.

During the inspection we spoke with one dentist, three dental nurses, one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Wednesday 8.30am - 5.30pm

Thursday 10.00am - 8.00pm

Friday 9.00am - 2.30pm

The practice is also open one Saturday per month between 9am and 1pm.

Our key findings were:

Staff had made many improvements to address the shortfalls that we identified during our inspection on 30 October 2018. These included:

  • Improvements in the practice’s recruitment procedures, staff training and immunisation records.
  • The storage and dispensing of medicines was in line with current guidance.
  • Recommended equipment maintenance checks and risk assessments had been completed.
  • Recommended audits were completed and at appropriate intervals.

However, there were areas where the provider could make improvements. They should:

  • Review the practice's Legionella risk assessment and implement any recommended actions, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
  • Review the development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment and appraisal of all staff. The practice should ensure that there is a nominated lead for infection control at the practice.

Inspection carried out on 30 October 2018

During a routine inspection

We carried out this announced inspection on 30 October 2018 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 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 not 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 not providing well-led care in accordance with the relevant regulations.

Background

Reece Associates LLP is in Sutton Coldfield and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available outside the practice but there are no dedicated car parking spaces for patients who are blue badge holders.

The dental team includes five dentists, eight dental nurses (two of whom are trainees), three dental hygienists, one dental hygiene therapist, two practice managers, one decontamination assistant and one receptionist. The dental nurses also carry out reception duties. There is also a visiting sedationist who provides sedation services for patients when needed. The practice had 5 treatment rooms at the time of our visit. However, it was undergoing refurbishment and will have 7 treatment rooms upon completion within the next month.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Reece Associates LLP is the practice manager.

On the day of inspection, we collected two CQC comment cards filled in by patients and spoke with one other patient.

During the inspection we spoke with two dentists, one dental nurse, one receptionist, the registered manager and the deputy practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Wednesday 8.30am - 5.30pm

Thursday 10.00am - 8.00pm

Friday 9.00am - 2.30pm

The practice is also open one Saturday per month between 9am and 1pm.

Our key findings were:

  • The practice appeared clean and well maintained. The structure and layout of the decontamination room required improvements. Staff had already identified this and these changes would be made shortly upon completion of the refurbishment.
  • The practice had infection control procedures which reflected published guidance. Some necessary improvements were required.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. One emergency medicine was not stored in accordance with manufacturer’s guidelines.
  • The practice had limited systems to help them manage risk.
  • The practice staff had safeguarding processes and they knew their responsibilities for safeguarding adults and children, although some of their training was overdue.
  • The practice had staff recruitment procedures but these were inconsistent and incomplete.
  • 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 did not have effective leadership.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice dealt with complaints positively and efficiently.
  • The practice had suitable information governance arrangements.

We identified regulations the provider was not meeting. They must:

  • Ensure care and treatment is provided in a safe way to patients
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider was not meeting are at the end of this report.

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

  • Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010. They should also review the availability of interpreting services for patients who do not speak or understand English.

Inspection carried out on 9 February 2012

During a routine inspection

As part of our review of the service, we spoke with two people during our visit and three people on the telephone following our visit.

20 surveys were returned to us from people using the service to tell us their views of the service provided.

People attending Reece dental practice on the day of our visit told us they were very happy with the service and treatment they received. They told us all treatment was explained to them and the choices they made were respected.

The staff are friendly and made them feel welcome and put them at ease.

They had no complaints about the service they received and were more then satisfied with their treatment.

Information taken from the surveys that people filled in included:

�Always helpful and informative��.

�They give you full details of the treatment they are planning to do and discuss all options with you��.

�Everyone in the practice is approachable and welcoming. I have been to other dentists before, but this is by far the best one��.

Information that we gathered during this review confirmed that people are assessed to decide what dental and oral healthcare needs they may have. The treatment that people had received had been discussed with them.

We found that people receive treatment in an environment, which was clean and managed to reduce the risk of infections