White Horse Health Centre

This practice is rated as Good overall. (Previous rating from October 2016 – Good)

The key questions at the October 2016 inspection were rated as:

• Are services safe? – Good
• Are services effective? – Good
• Are services caring? – Good
• Are services responsive? – Good
• Are services well-led? – Good

We carried out an announced comprehensive inspection at White Horse Health Centre on 29 & 30 August 2018, as part of our inspection programme.

At this inspection we found:

• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• The practice had developed a clear dementia strategy to improve their care for patients with this illness, which included an action plan. This included the practice working to become accredited as being a dementia friendly service.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements are:

• The practice must ensure all staff receive such appropriate support, training, professional development, as is necessary to enable them to carry out the duties they are employed to perform.

The areas where the provider should make improvements are:

• Improve systems for the handling, monitoring and recording of safety alerts.
• The practice must act to reduce their exception reporting rates.
• Improve systems for monitoring all prescription forms.
• Improve systems for recording staff DBS checks.
• Improve systems to ensure all complainants are given information about how to escalate their complaint if they were unsatisfied with the practice response.
• The provider should continue to make efforts to increase the programme coverage of women eligible to be screened for cervical cancer.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

We carried out this announced inspection on 29 August 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a second inspector and specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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

White Horse Health Centre dentistry department provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including allocated parking for disabled patients, are available in the car park at the front of the practice.

The dental team includes two dentists, one dental hygienist, three dental nurses, a receptionist and a manager. The practice has three treatment rooms.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at White Horse Health Centre is the health centre manager.

On the day of inspection, we collected 16 CQC comment cards filled in by patients and obtained the views of eight other patients.

During the inspection we spoke with a dentist, hygienist, receptionist, two practice nurses and the registered manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open 7.45am to 5pm Monday to Wednesday, 7.45am to 7pm Thursday and 7.45am to 4pm on Friday. The practice closes for lunch between 12 noon and 1pm daily.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice could not demonstrate effective clinical leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice dealt with complaints positively and efficiently.

There were areas where the provider could make improvements. They should:

• Review the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term.