Updated 9 December 2019
We carried out this announced inspection on 7 November 2019 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 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
Smith and Smith Dental Practice Partnership is in Gateshead and provides NHS and private dental treatment to adults and children.
Access for people who use wheelchairs and those with pushchairs is restricted as the practice entrance has three steps in front, and use of a portable ramp is not possible due to the steepness of the steps. Patients are made aware of this prior to booking an appointment. Car parking spaces are available near the practice.
The dental team includes seven associate dentists, six dental nurses, one dental hygienist and a receptionist. A practice manager, area manager and clinical advisor support the dental team. The practice has five 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 Smith and Smith Dental Practice Partnership is the practice manager.
On the day of inspection, we collected nine CQC comment cards filled in by patients. These provided a positive view of the dental team and care provided by the practice.
During the inspection we spoke with three dentists, three dental nurses, the receptionist, the practice manager and the area manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday, Tuesday, Wednesday 9am to 8pm
Thursday and Friday 9am to 5.30pm.
Our key findings were:
- The practice appeared clean and well maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider had systems to help them manage risk to patients and staff. They should review their risk management systems in relation to the security of clinical waste storage, radiation protection and sharps injuries.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider 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.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and culture of continuous improvement.
- Staff felt involved and supported and worked well as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- The provider had suitable information governance arrangements.
There were areas where the provider could make improvements. They should:
- Improve the practice's waste handling protocols to ensure waste is stored in compliance with the relevant regulations, and taking into account the guidance issued in the Health Technical Memorandum 07-01. In particular, they should improve the security of the clinical waste bins outside, to ensure they are not accessible to public.
- Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment.
- Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, improve the security of unauthorised access into the basement surgery.
- Implement an effective system for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
- Implement an effective system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result. In particular, ensure staff are aware of, and follow, the practice’s sharps injury protocols.