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Inspection Summary


Overall summary & rating

Updated 7 February 2017

 

We carried out an announced comprehensive inspection on 10 January 2017 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

Belmont dental practice is situated in County Durham and provides predominantly private treatment to patients of all ages. The entrance is located on the ground floor and the remainder of the practice is on the first floor. There are two treatment rooms, two dedicated decontamination rooms for sterilising dental instruments, a reception, a segregated waiting area, a staff room and general office. Car parking is available within the premises and on the side-streets near the practice. Access for wheelchair users or pushchairs is possible via a portable ramp and a stair-lift is available for aiding people up and down the stairs.

The practice is open Monday and Tuesday 8am - 7pm, Wednesday and Thursday 8am - 5pm and

Friday 8am - 1pm.

The dental team is comprised of two principal dentists, two associate dentists, a dental hygienist, four qualified dental nurses and the receptionist who is also the staff liaison officer.

One of the principal dentists is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.

The practice offers general and specialised dental treatments including dental implants and conscious sedation.

We reviewed 40 CQC comment cards on the day of our visit; patients were very positive about the staff and standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

  • Staff were very friendly, caring and enthusiastic.
  • The practice was visibly clean and an Infection prevention and control policy was in place.
  • We saw sterilisation procedures followed recommended guidance.
  • The practice had systems for recording incidents and accidents.
  • Dental professionals provided treatment in accordance with current professional guidelines.
  • Patient feedback was regularly sought and reflected upon.
  • Patients could access urgent care when required.
  • Dental professionals were maintaining their continued professional development (CPD) in accordance with their professional registration.
  • Complaints were dealt with in an efficient and positive manner.
  • Staff received annual medical emergency training.
  • Equipment for dealing with medical emergencies reflected guidance from the resuscitation council.
  • Staff were aware on how to escalate safeguarding issues for children and adults should the need arise. Contact details were available within their safeguarding policy.
  • Staff were involved in providing oral health education to local schools and scouting groups.
  • Recruitment and training procedures were not consistent.
  • Staff were not fully aware of all relevant safety alerts from the Medicines and Healthcare products Regulatory Agency (MHRA) and Central Alerting System (CAS).

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

  • Review the practice's recruitment policy and procedures to ensure recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and to ensure necessary employment checks are in place for all staff. This includes ensuring verbal references are written down and the required specified information in respect of persons employed by the practice is held.

  • Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
  • Review the practice’s safeguarding protocols and ensure all staff have had training at an appropriate level, in the safeguarding of children and vulnerable adults and understand the prinicples of the Mental Capacity Act 2005.
Inspection areas

Safe

No action required

Updated 7 February 2017

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

Infection prevention and control procedures followed recommended guidance from the Department of Health: Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices.

Equipment for decontamination procedures, radiography and general dental procedures were tested and checked according to manufacturer’s instructions.

Medicines were stored appropriately, both for medical emergencies and for regular use and were in accordance with the British National Formulary (BNF) and Resuscitation Council UK guidelines.

The practice had processes for recording and reporting any accidents and incidents.

Risk assessments (a system of identifying what could cause harm to people and deciding whether to take any reasonable steps to prevent that harm) were in place for the practice.

The associate dentist received safety alerts from the Medicines and Healthcare products Regulatory Agency (MHRA) and Central Alerting System (CAS). These were not fully distributed amongst all staff within the practice and the principal dentists were not aware of all recent safety alerts.

Effective

No action required

Updated 7 February 2017

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

Dental professionals referred to resources such as the National Institute for Health and Care Excellence (NICE) guidelines and the Delivering Better Oral Health toolkit (DBOH) to ensure their treatment followed current recommendations.

Staff obtained consent, dealt with patients of varying age groups and made referrals to other services in an appropriate and recognised manner.

Staff who were registered with the General Dental Council (GDC) met the requirements of their professional registration by carrying out regular training and continuing professional development (CPD).

Caring

No action required

Updated 7 February 2017

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

Patients were very positive about the staff, practice and treatment received. We left CQC comment cards for patients to complete two weeks prior to the inspection. There were 40 responses all of which were very positive, with patients stating they felt listened to and received the best treatment at that practice.

We observed patients being treated with respect and dignity during our inspection and privacy and confidentiality were maintained for patients using the service. We also observed staff to be welcoming and caring towards patients.

The waiting area was equipped with dental advice and practice information leaflets, tea/coffee and water facilities and a child play area.

Dental care records were kept securely and computers were password protected.

Responsive

No action required

Updated 7 February 2017

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

the relevant regulations.

The practice had dedicated slots each day for urgent dental care and every effort was made to see all emergency patients on the day they contacted the practice.

The practice had considered the needs of various population groups and implemented a hearing loop at reception, offered large print leaflets and had access to telephone interpreter services when required. A stair-lift was installed to enable people to ascend/descend the staircase and the practice could accommodate wheelchair users/pushchairs within their surgeries and patient toilet.

Well-led

No action required

Updated 7 February 2017

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

The principal dentists were on-site every day of the week and were available by phone when not present. There were dedicated leads in infection prevention and control and safeguarding as well as various policies for staff to refer to.

The principal dentists kept all staff files, training logs and certificates on the premises; these were not complete for all members. There was no method of monitoring training.

There were regular quality checks of clinical and administration work; the practice undertook a range of audits and risk assessments.

Staff were encouraged to provide feedback on a regular basis through staff meetings and informal discussions.

Patient feedback was also encouraged verbally and online. The results of any feedback were discussed in meetings for staff learning and improvement.