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Inspection Summary


Overall summary & rating

Updated 26 May 2017

We carried out an announced comprehensive inspection on 22 February 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

Soar Valley Dental Practice is a dental practice providing primarily private with some NHS care for adults and children. Where private treatment is provided some is under a fee per item basis and some under a dental insurance plan. The practice is situated in a converted property and has three dental treatment rooms; one on the ground floor and two on the first floor. There is also a reception and waiting area on the ground floor and a waiting room and a care suite on the first floor. The care suite was used for private discussions regarding treatments with patients. There were also other rooms used by the practice for office facilities and storage. The practice is open from 9.00am to 6.00pm Monday to Thursday and from 9.00am to 2.00pm on Fridays. The practice closes for lunch from 1.00pm to 2.00pm.

The practice has two full time dentists, one of them being the principal dentist and the other a foundation dentist (a foundation dentist is a dentist undertaking a post-qualification training period, in general dental practice. UK graduates need to undertake this in order to work in NHS practice). There are also two part time associate dentists. They are supported by three dental nurses, a trainee dental nurse, three part time dental hygienists, a practice manager, a care coordinator and two receptionists.

The practice is able to provide general dental services including endodontic (root canal) treatment, orthodontic treatment and some cosmetic dentistry.

The principal dentist is registered with the Care Quality Commission as an individual and also as the registered manager. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience. We also spoke with patients on the day of our inspection. We received feedback from a total of eleven patients. All feedback was positive with patients commenting favourably on the quality of care and service they received, the professional and helpful nature of staff and the cleanliness of the practice.

Our key findings were:

  • Staff reported incidents which were investigated, discussed and learning implemented to improve safety.
  • The practice was visibly clean and well maintained and Iinfection control procedures were in line with the requirements of the ‘Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices’ published by the Department of Health, with the exception of incomplete records of water temperature monitoring in relation to the risks associated with legionella.
  • The practice had medicines and equipment for use in a medical emergency which were in accordance with national guidelines with the exception that there were no paediatric masks and the tubing on the portable suction was too short. We were informed following our inspection that these items had been purchased.
  • Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).

  • Staff demonstrated a strong commitment to oral health promotion and the foundation dentist and oral health educator carried out visits to local schools and playgroups to give talks to children to promote oral health.

  • Patients commented that they were pleased with the care they received and that staff were helpful, kind and courteous.

  • The practice had suitable facilities and was equipped to treat patients and meet their needs. However we found that there were gaps in the recording of testing of equipment used in the decontamination process. We were told following our inspection that the process had been changed to ensure this would not happen again.

  • Translation services were available. There was no hearing loop to assist patients with a hearing impairment but the practice told us they had purchased one following our inspection.

  • The practice had a process in place to make referrals to other dental professionals when appropriate to do so but there was no system to track referrals.

  • Governance arrangements were in place for the smooth running of the service.

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

  • Review the practice’s referral processes to allow referrals to be monitored.
  • Review the current arrangements for recording of water temperatures in respect of mitigating the risks associated with legionella, giving regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance
  • Review the systems in place to ensure that the equipment used in the decontamination process is working effectively.
Inspection areas

Safe

No action required

Updated 26 May 2017

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

The practice had a system in place to identify, investigate and learn from significant events.

There were sufficient numbers of suitably qualified staff working at the practice to meet patients’ needs.Staff had received safeguarding training and were aware of their responsibilities regarding safeguarding children and vulnerable adults.

Infection control procedures were in line with the requirements of the ‘Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices’ published by the Department of Health, with the exception of incomplete records of water temperature monitoring in relation to the risks associated with legionella.

The practice had medicines and equipment for use in a medical emergency which were in accordance with national guidelines with the exception that there were no paediatric masks and the tubing on the portable suction was too short. We were informed following our inspection that these items had been purchased.

Use of X-rays on the premises was in line with the regulations.

Effective

No action required

Updated 26 May 2017

We found that 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 clinicians used current national professional guidance including that from the National Institute for Health and Care Excellence (NICE) to guide their practice.

Staff demonstrated a strong commitment to oral health promotion and the foundation dentist and oral health educator carried out visits to local schools and playgroups to give talks to children to promote oral health.

The staff received ongoing professional training and development appropriate to their roles and learning needs.

Clinical staff were registered with the General Dental Council (GDC) and were meeting the requirements of their professional registration

The practice had a process in place to make referrals to other dental professionals when appropriate to do so but there was no system to track referrals.

Caring

No action required

Updated 26 May 2017

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

We received feedback from eleven patients and this provided a positive view of the service the practice provided. Comments reflected that patients were highly satisfied with the care they received and commented on the welcoming and helpful nature of the staff. Patients told us they were treated as individuals and treatment options were explained to them and they were involved in decisions about their treatment.

We observed that patients were treated with dignity and respect and the confidentiality of patients’ private information was maintained.

Responsive

No action required

Updated 26 May 2017

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

The practice had good facilities and was equipped to treat patients and meet their needs.

Routine dental appointments were available, as were urgent on the day appointments. Patients told us they found it easy to get an appointment in a timely way.

Information was available for patients in the practice and on the practice’s website.

The practice was in a converted building and patient services were available on the ground floor of the building which was wheelchair accessible. There were further treatment rooms on the first floor.

Information about how to complain was available to patients and complaints were responded to appropriately.

The practice had access to telephone interpreter services should they be required for patients who did not speak English. There was no hearing loop to assist patients with a hearing impairment but the practice told us they had purchased one following our inspection.

Well-led

No action required

Updated 26 May 2017

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

There was an open culture and staff were well supported and able to raise any concerns. .

Clinical audit was used as a tool to highlight areas where improvements could be made.

Feedback was obtained from patients and discussed and acted upon to make changes to the service provided if appropriate.

Systems and processes within the practice were operated effectively. Governance arrangements were in place. There were policies and protocols available which were regularly reviewed and updated. Risks had been assessed and mitigating actions put in place.