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Inspection Summary


Overall summary & rating

Updated 2 September 2016

We carried out an announced comprehensive inspection on 4 August 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

Kingsway Dental Practice is located in a residential suburb close to the centre of Chester and comprises a reception and waiting room, two treatment rooms and an office / storage / staff room. Parking is available outside the premises. The practice is accessible to patients with disabilities, impaired mobility and to wheelchair users.

The practice provides general dental treatment to patients on an NHS or privately funded basis. The opening times are Monday to Thursday 9.00am to 5.30pm and Friday 9.00am to 2.00pm. The practice is staffed by a principal dentist, two associate dentists, three dental nurses who are also receptionists, and a trainee dental nurse.

The principal dentist is registered with the Care Quality Commission as an individual. 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.

We received feedback from 33 people during the inspection about the services provided. Patients commented that they found the practice excellent and well organised, and that staff were very helpful, welcoming and caring. They said they were always given good and clear explanations about dental treatment and options, and that the dentists listened to them. Patients commented that the practice was clean and comfortable. Patients were particularly complimentary about the availability of emergency appointments. One patient commented that it would be difficult to improve the service.

Our key findings were:

  • The practice had procedures in place to record and analyse significant events and incidents.
  • Staff had received safeguarding training and knew the process to follow to raise concerns.
  • There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
  • Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
  • The premises and equipment were clean, secure and well maintained.
  • Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards and guidance.
  • Patients received information about their care, proposed treatment, costs, benefits and risks and were involved in making decisions about it.
  • Staff were supported to deliver effective care, and opportunities for training and learning were available.
  • Patients were treated with kindness, dignity and respect, and their confidentiality was maintained.
  • The appointment system met the needs of patients, and emergency appointments were available.
  • The practice gathered the views of patients and took into account patient feedback.
  • Staff were supervised, felt involved and worked as a team.
  • Governance arrangements were in place for the smooth running of the practice and for the delivery of high quality person centred care.
  • The provider had infection prevention and control procedures in place and staff followed current guidelines for the decontamination of equipment however some improvements were needed to instrument storage.
  • Services were planned and delivered to meet the needs of patients and reasonable adjustments were made to enable patients to receive their care and treatment; however a formal Disability Discrimination Audit had not been carried out.

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

  • Review the practice’s infection prevention and control procedures and protocols in relation to instrument storage and cleaning equipment having due regard to guidelines issued by the Department of Health in the 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 requirements of the Disability Discrimination Act and ensure an audit of the premises is undertaken.
  • Ensure the storage of records relating to people employed is in accordance with current legislation and guidance.
Inspection areas

Safe

No action required

Updated 2 September 2016

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

The provider had effective systems and processes in place to ensure that care and treatment were carried out safely, for example, there were systems in place for infection prevention and control, the management of medical emergencies, dental radiography, and investigating and learning from incidents and complaints.

Staff had received training in safeguarding adults and children and knew how to recognise the signs of abuse and who to report them to.

Staff were appropriately recruited, suitably trained and skilled, and there were sufficient numbers of staff. Regular appraisals were carried out and we saw evidence of inductions for new staff.

We found the equipment used in the practice, including medical emergency and radiography equipment, was well maintained and tested at regular intervals. The practice had emergency medicines and equipment available, including an automated external defibrillator. Staff were trained in dealing with medical emergencies.

The premises was secure and properly maintained. The practice was cleaned regularly and there was a cleaning schedule in place identifying tasks to be completed.

Staff had received training in infection prevention and control. There was guidance for staff on effective decontamination of dental instruments which staff were following; however improvements were needed to the storage of some instruments.

The practice was following current legislation and guidance in relation to X-rays to protect patients and staff from unnecessary exposure to radiation.

Effective

No action required

Updated 2 September 2016

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

Dentists followed current guidelines when delivering dental care and treatment to patients. This included assessing and recording their medical history. Patients received an assessment of their dental needs and treatment provided focused on their individual needs. Explanations were given to patients in a way they understood, and risks, benefits, options and costs were fully explained. Patients’ consent was obtained before treatment was provided. Patients were given a written treatment plan which detailed the treatments considered and agreed together with the fees involved. The dentists kept detailed dental records.

The dentists provided oral health advice and guidance to patients and monitored changes in their oral health. Patients were referred to other services where necessary, in a timely manner.

Qualified staff were registered with their professional body, the General Dental Council. Staff received training and were supported in meeting the requirements of their professional regulator.

Caring

No action required

Updated 2 September 2016

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

Patients commented that staff were caring and friendly. They told us they were treated with respect and that they were happy with the care and treatment given.

Staff understood the importance of emotional support when delivering care to patients who were nervous of dental treatment. Patient feedback on CQC comment cards confirmed that staff were understanding and made them feel at ease.

The practice had separate rooms available if patients wished to speak in private.

We found that treatment was clearly explained and patients were provided with information regarding their treatment and oral health. Patients were given time to decide before treatment was commenced. Patients commented that information given to them about options for treatment was helpful.

Responsive

No action required

Updated 2 September 2016

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

Patients had access to appointments to suit their preferences, and emergency appointments were available on the same day. Patients could request appointments by telephone or in person. The practice opening hours and the ‘out of hours’ appointment information was provided at the entrance to the practice and in the patient leaflet.

The practice captured social and lifestyle information on the medical history forms completed by patients which helped the dentist to identify patients’ specific needs and direct treatment to ensure the best outcome was achieved for the patient. Staff were prompted to be aware of patients’ specific needs or medical conditions via the use of a flagging system on the dental care records.

The practice had not carried out a Disability Discrimination Act audit; however the provider had taken into account the needs of different groups of people, for example, people with disabilities, impaired mobility, and wheelchair users and made adjustments accordingly.

The practice had a complaints policy in place which was displayed in the waiting room and outlined in the practice leaflet. Complaints were thoroughly investigated and responded to appropriately.

Well-led

No action required

Updated 2 September 2016

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

The provider had effective systems and processes in place for monitoring and improving services.

The practice had a management structure in place and some of the staff had lead roles. Staff were aware of their roles and responsibilities. Staff reported that the provider was approachable and helpful, and took account of their views. The culture of the practice encouraged openness and honesty and staff told us they were encouraged to raise any issues or concerns.

The provider had implemented a range of policies, procedures and protocols to guide staff in undertaking tasks, and used a variety of means to monitor quality and safety at the practice and to ensure continuous improvement, for example, learning from complaints and gathering patient feedback.

Staff were aware of the importance of confidentiality and understood their roles in this. Dental care records were complete, accurate and securely stored. Patient information was handled confidentially.

The practice held regular staff meetings and these were used to share information to improve future practice and gave everybody an opportunity to openly share information and discuss any concerns or issues.