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Inspection Summary


Overall summary & rating

Updated 13 February 2017

We carried out an announced comprehensive inspection on 6 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Advance Dental Practice is a dental practice providing predominantly private treatment for adults and children. They also provide NHS treatment for children and some patients referred via the dental access centre. Advance Dental Practice was established in 1999. The practice is both purpose built and spacious and is located on a business park. The location provides free parking and is wheelchair accessible to all patient areas.

The practice operates an extraction clinic operating on Tuesday mornings with patient assessments carried out Tuesday or Wednesday afternoons, this enabled any urgent cases to be seen in a timely manner. The purpose of this clinic is that local dentists could refer cases to the practice for a rapid service.

The practice employs one dentist, one hygienist, two dental nurses and two reception staff. Fees are displayed on the practice website.

The practice opens Monday to Friday between 9am and 5pm. They can also offer a Saturday morning appointment service by prior arrangement. There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. This is provided by an out-of-hours service. If patients called the practice when it was closed, an answerphone message gives the telephone number patients should ring depending on their symptoms.

The practice owner is also 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.

During our inspection we reviewed seven CQC comment cards completed by patients and obtained the view of three patients on the day of our inspection.

The inspection was carried out by a lead inspector and a dental specialist advisor.

Before the inspection, we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from seven patients. In addition we spoke with three patients on the day of our inspection. Feedback from patients was positive about the quality of care, the caring nature of all staff and the overall high quality of customer care. They commented that staff put them at ease and listened to their concerns. They also reported they felt proposed treatments were fully explained them so they could make an informed decision which gave them confidence in the care provided.

Our key findings were:

  • We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
  • Effective leadership was provided by the principal dentist and an empowered lead dental nurse.
  • Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
  • Premises appeared well maintained and visibly clean. Good cleaning and infection control systems were in place and the practice followed published guidance.
  • The treatment rooms were well organised and equipped, with good light and ventilation.
  • There were systems in place to check all equipment had been serviced regularly, including the autoclaves and the X-ray equipment.
  • The practice had a safeguarding lead professional and effective processes in place for safeguarding adults and children.
  • There was a policy and procedure in place for recording adverse incidents and accidents.
  • The dentist and dental hygienist provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
  • The dentist used Loupes – these enable the clinician to have a magnified view of the operation site thus enabling accuracy of treatment.
  • The practice had a system to monitor and continually improve the quality of the service; including through a programme of clinical and non-clinical audits.
  • Patients could access treatment and urgent and emergency care when required.
  • Staff had received training appropriate to their roles and were supported in their continuing professional development by the practice owner.
  • Staff we spoke with felt well supported by the practice owner and were committed to providing a quality service to their patients.
  • Information from seven completed Care Quality Commission (CQC) comment cards and speaking to patients gave us a positive picture of a friendly, caring, professional and high quality service.
  • The practice reviewed and dealt with complaints according to their practice policy.

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

  • Review the practice web site to ensure that information is kept up to date
  • Review access to interpreter services for consultations with patients whose first language is not English.
Inspection areas

Safe

No action required

Updated 13 February 2017

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

The practice had effective arrangements in place to help ensure the safety of staff and patients. This included for essential areas such as infection control and the management of medical emergencies and dental radiography (X-rays).

We found all the equipment used in the dental practice was well maintained. The practice took their responsibilities for patient safety seriously and staff were aware of the importance of identifying and investigating patient safety incidents.

Staff had received safeguarding training and were aware of their responsibilities regarding safeguarding children and vulnerable adults.

The practice carried out and reviewed risk assessments to identify and manage risks.

There were clear procedures regarding the maintenance of equipment and the storage of medicines in order to deliver care safely and in an emergency.

Effective

No action required

Updated 13 February 2017

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

The dental care provided was evidence based and focussed on the needs of the patients. The practice used current national professional guidance including that from the National Institute for Health and Care Excellence (NICE) to guide their practice.

We saw examples of positive teamwork within the practice and evidenced good communication with other dental professionals. The staff received professional training and development appropriate to their roles and learning needs. Staff we spoke with told us they had accessed specific training in the last 12 months in line with their professional development plan and in line with General Dental Council (GDC) requirements for registrants.

Staff where appropriate were registered with the GDC and were meeting the requirements of their professional registration.

They monitored any changes in the patient’s oral health and made referrals as appropriate to other primary and secondary care providers such as for specialist orthodontic treatment or hospital services for further investigations or treatment as required.

The practice was proactive in providing patients with advice about preventative care and supported patients to ensure better oral health in line with Public Health England publication ‘Delivering better Oral Health 3rd edition. (DBOH).

Caring

No action required

Updated 13 February 2017

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

We reviewed seven completed CQC comments and received feedback on the day of the inspection from three patients about the care and treatment they received at the practice.

Patients commented the quality of care was very good. Patients commented on the friendliness and helpfulness of the staff and told us dentists were good at explaining the treatment that was proposed.

We observed privacy and confidentiality were maintained for patients using the service on the day of the inspection. Policies and procedures in relation to data protection, security and confidentiality were in place and staff were aware of these.

Responsive

No action required

Updated 13 February 2017

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

Patients could access treatment and urgent and emergency care when required. The practice provided patients with written information. The practice had experienced very few requests for treatment by patients whose first language was not English. Whilst they could provide information about treatments in another language, the practice should consider access to interpreter services for consultations.

There was level access into the building for patients with limited mobility, or those with prams and pushchairs. We observed the reception desk was compliant with the Equality Act 2010. Although there was no hearing loop available, information and forms were available and could be printed in large print when required.

There was a procedure in place for acknowledging, recording, investigating and responding to complaints and concerns made by patients or their carers.

Well-led

No action required

Updated 13 February 2017

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

We found effective leadership was provided by the principal dentist and an empowered lead dental nurse. Staff had an open approach to their work and shared a commitment to continually improving the service they provided. There was a no blame culture in the practice.

The practice maintained a comprehensive system of policies and procedures using a commercially available dental clinical governance system which had recently been introduced by the principal dentist. Staff told us they felt well supported and could raise any concerns with the principal dentist. All the staff we met said they were happy in their work and the practice was a good place to work.

The practice assessed risks to patients and staff and carried out a programme of audits as part of a system of continuous improvement and learning. There were clearly defined roles within the practice and staff told us they felt well supported and enjoyed their work.

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