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Inspection Summary


Overall summary & rating

Updated 18 January 2017

We carried out an announced comprehensive inspection on 22 December 2016 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

Bishopsgate Dental Care in Bishopsgate, London provides private dental treatment to patients of all ages. The practice also provides conscious sedation and minor oral surgery services. [Conscious sedation is a procedure using a combination of medicines to help a patient to relax (a sedative) and to block pain (an anaesthetic) during a medical or dental procedure. The patient remains awake during the whole procedure].

Practice staffing consists of a principal dentist, four associate dentists, orthodontic therapist, one hygienist, two dental nurses, one trainee dental nurse, one receptionist and a practice manager.

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.

The practice is open Monday to Thursday 8am to 8pm and Friday 8am to 2pm

The practice facilities include three treatment rooms a decontamination room, reception/waiting area, one office and a staff room/kitchen.

40 patients provided feedback about the service. Patients who completed comment cards were very positive about the care they received from the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

  • Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
  • The practice sought feedback from patients about the services they provided and acted on this to improve its services.
  • Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
  • The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
  • There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
  • Equipment, such as the autoclaves, fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
  • Patients were treated with dignity and respect and confidentiality was maintained.
  • Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
  • Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.

  • Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical audits were carried out to monitor the quality of services.
Inspection areas

Safe

No action required

Updated 18 January 2017

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

The practice was visibly clean and infection control procedures were in line with national guidance.

The cleaning and decontamination of dental instruments was carried out in line with current guidelines. Regular audits and checks were carried out to ensure that the infection control arrangements were effective.

Patients were protected against the risks of abuse or harm through the practice policies and procedures. Staff were trained to recognise and report concerns about patients’ safety and welfare and had access to contact details for the local safeguarding team.

There was a range of equipment and medicines for use in medical emergencies and these were in line with national guidance. Staff had undertaken appropriate training. Medicines and equipment were stored appropriately, accessible and regularly checked.

The practice had undertaken a risk assessment in relation to the Control of Substances Hazardous to Health 2002 (COSHH) regulations.

Effective

No action required

Updated 18 January 2017

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

The staff kept their training up-to-date and received professional development appropriate to their role and learning needs. Staff who were registered with the General Dental Council (GDC) demonstrated that they were supported by the practice in continuing their professional development (CPD) and were meeting the requirements of their professional registration.

Health education for patients was provided by the dentists and hygienist; information leaflets were available within the practice. They provided patients with advice to improve and maintain good oral health.

Patients were offered options of treatments available and were advised of the associated risks and intended benefits. Patients' consent was obtained and they were provided with a detailed written treatment plan which described the treatments considered and agreed together with the proposed timeframe for completions and the fees involved.

The practice provided evidence-based care in accordance with relevant, published guidance, for example, from the Faculty of General Dental Practice (FGDP), National Institute for Health and Care Excellence (NICE), Department of Health (DH) and the General Dental Council (GDC).

Caring

No action required

Updated 18 January 2017

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

Patients were complimentary about the practice and how the staff treated them. Patients commented positively on how caring and helpful staff were, describing them as friendly, compassionate and professional.

Patients felt listened to and were given appropriate information and support regarding their care or treatment. They felt their dentist explained the treatment they needed in a way they could understand. Staff had a good awareness of how to support patients who may lack capacity to make decisions about their dental care and treatment.

The practice had procedures in place for respecting patients’ privacy, dignity and providing compassionate care and treatment. An office was available should patients wish to speak confidentially with the dentist or reception staff. Staff had undertaken training around respecting and promoting equality and diversity.

Responsive

No action required

Updated 18 January 2017

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

The practice had a complaints process which was available to support any patients who wished to make a complaint. The process described the timescales involved for responding to a complaint and who was responsible in the practice for managing them. Complaints were investigated and responded to in a timely manner and a suitable explanation and apology was offered.

Appointment times met the needs of patients and waiting times were kept to a minimum. Staff told us all patients who requested an urgent appointment would be seen where possible on the same day or within 24 hours.

Patients who had difficulty understanding care and treatment options were suitably supported.

The practice had a procedure in place for dealing with complaints.

Well-led

No action required

Updated 18 January 2017

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

The nurse described an open and transparent culture where they were comfortable raising and discussing concerns with each other.

There was a pro-active approach to identify safety issues and make improvements in procedures. There was candour, openness, honesty and transparency amongst all staff we spoke with.

Patients’ views were regularly sought by way of a patient survey and these were acted upon as required

The dental care records were maintained appropriately giving due regard to guidance provided by the Faculty of General Dental Practice (FGDP) regarding clinical examinations and record keeping.