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Inspection Summary


Overall summary & rating

Updated 7 January 2016

We carried out an announced comprehensive inspection on 23 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

MK Dental Spa is a predominantly private dental practice situated on the first floor of a purpose built building in the Kiln Farm area of Milton Keynes.

The practice has a range of dental specialists, and operates a referral system whereby other practices can refer their patients for specific specialist treatments, such as endodontics (root canal treatment) periodontics (gum treatment) and dental implants (where a titanium post is placed surgically into the jaw bone. It is then used to replace a tooth, or support a bridge or denture). In addition an oral surgeon with a National Health Service (NHS) contract works two days a week. Patients requiring oral surgery (tooth extractions etc.) can be referred on the NHS.

The practice is open from 8.45 am to 5.30 pm Monday, Tuesday, Thursday and Friday. 8.45 am to 6.30 pm on Wednesday and alternate Saturday mornings by appointment only.

The principal dentist is 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.

25 patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with patients on the day of the inspection. Overall the information from patients was very positive. Patients were positive about their experience and they commented that they were treated with kindness and respect.

Our key findings were:

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

  • Governance arrangements were in place for the smooth running of the practice; however the practice did not retain information regarding continuous professional training of individual staff. For this reason the registered manager could not be assured that all required training was up to date in accordance with the requirements of the General Dental Council.

  • Robust systems were in place to ensure that patients were able to provide valid, informed and educated consent.

  • The practice had good systems and adequate training in place for providing conscious sedation to patients (these are techniques in which the use of a drug or medicine or medicines produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation).

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

  • Review availability and staff knowledge of equipment and medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), the British National Formulary, and the General Dental Council (GDC) standards for the dental team.

  • Review at appropriate intervals the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.

  • 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.

Inspection areas

Safe

No action required

Updated 7 January 2016

We found that this practice was providing safe care in accordance with

the relevant regulations.

Staff demonstrated a good knowledge of how to raise a safeguarding concern for a child or vulnerable adult. They were able to describe the types of scenario which may cause them to raise a concern.

Medicines and equipment were in place to deal with medical emergencies, although some staff were not able to tell us where individual medicines were kept. The medicine in question is now stored with the other emergency medicines.

Recruitment checks on staff were carried out in accordance with schedule three of the Health and Social Care Act 2008.

Decontamination of dental instruments was carried out in accordance with the ‘Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices.’ Published by the Department of Health.

Effective

No action required

Updated 7 January 2016

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

Staff had an excellent understanding of national guidelines available to aid diagnosis and treatment.

The practice had three dental nurses that had been trained in sedation; this is a requirement of the Standards for Conscious Sedation in the Provision of Dental Care 2015 guidelines produced by the Intercollegiate Advisory Committee for the Provision of Sedation in Dentistry.

Staff we spoke with had a thorough understanding and approach to gaining consent for treatment.

Caring

No action required

Updated 7 January 2016

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

the relevant regulations.

Staff members demonstrated their knowledge of data protection and how to maintain confidentiality.

Feedback that we received from patients to the service described how they were always treated in a kind and friendly manner. Nervous patients reported how they were put at ease in this practice.

Responsive

No action required

Updated 7 January 2016

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

The practice responded to patient requests to have appointments available at the weekends; the practice now opens every other Saturday with appointments available all day.

We saw evidence that complaints were thoroughly investigated, and where appropriate, apologies issued to the patients involved in a timely manner.

Well-led

No action required

Updated 7 January 2016

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

Quality assurance processes were in place at the practice to ensure continuous improvement. Clinical audit was used to identify areas where improvements to practice could be made.

The practice had systems in place to involve, seek and act upon feedback from people using the service.

Continuous professional development requirements in mandatory training were not monitored by the registered manager, therefore assurances could not be given that staff had carried out their mandatory training. We have been provided evidence since our visit that a comprehensive monitoring schedule was now in place for all staff.