Acorn Dental Care

We carried out an announced comprehensive inspection on 16 June 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 not providing well-led care in accordance with the relevant regulation.

Background

Acorn Dental operates from a converted domestic dwelling and provides NHS and private dentistry for both adults and children. The practice is situated in Slough, Berkshire.

The practice has two dental treatment rooms which are based on the ground floor. The practice has a separate decontamination room used for cleaning, sterilising and packing dental instruments.

The practice employs two dentists, a hygienist, two dental nurses, of which one is the practice manager, two trainee dental nurses and one receptionist.Appointments are available Monday to Friday between 8am and 5pm. Emergency dental treatment is available between 8am and 10pm seven days a week (by appointment after 5pm).

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 call the practice when it is closed, an answerphone message gives the telephone number patients should ring depending on their symptoms.

The practice owner 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.

During our inspection we reviewed 41 CQC comment cards completed by patients and obtained the view of 14 patients on the day of our inspection.

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

Our key findings were:

• The practice ethos was to achieve high quality patient centred care.

• The practice owner provided effective clinical support and supervision for dentists working in the practice.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.

• The practice was visibly clean and well maintained.

• Infection control procedures followed published guidance.

• There were processes in place for safeguarding adults and children living in vulnerable circumstances.

• Patients could access treatment and urgent and emergency care when required.

• There were areas where the provider should improve access for disabled patients and patients with mobility difficulties.

• The practice maintained a system of policies and procedures; however there were shortfalls within the system. This included files containing policies and procedures from several different compliance systems which led to confusion with respect to operating practice policies, procedures and protocols.

• Staff recruitment files were not always complete.

• Fire safety control measures were not effective.

• Most staff received training appropriate to their roles and were supported in their continued professional development (CPD) but there were shortfalls in the recording system for training.

• Staff we spoke with were committed to providing a quality service to their patients.

• Information from 41 completed Care Quality Commission (CQC) comment cards gave us a completely positive picture of a friendly, professional service.

• The practice had a system of clinical and non-clinical audit in place.

We identified regulations that were not being met and the provider must:

• Ensure the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.
• Ensure that a system for collating the records of training of relevant staff members is established.

You can see full details of the regulations not being met at the end of this report.

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

• Provide an annual statement in relation to infection prevention and control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance is prepared.

• Review the timing of the visual checking of electrical appliances between formal portable appliance testing.

• 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).