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Inspection Summary


Overall summary & rating

Updated 14 November 2016

We carried out an announced comprehensive inspection on 14 October 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

Quarry House Dental Practice is situated in Leeds, West Yorkshire. The practice is based in Quarry House which houses offices for the Department of Health and the Department for Work and Pensions.

The practice only offers appointments to staff working at Quarry House and their families and this incudes NHS dental treatments and private treatments. The services include preventative advice and treatment and routine restorative dental care.

The practice has one surgery, a waiting area and a reception area. There are accessible toilet facilities available. The practice is fully accessible for patients with limited mobility as lifts are available within Quarry House.

There are two dentists, one dental hygienist, two dental nurses, one receptionist and a practice manager.

The opening hours are Monday from 8-45am to 4-00pm, Tuesday from 8-45am to 4-45pm, Wednesday from 8-45am to 3-00pm, Thursday from 9-00am to 1-00pm (hygienist service only) and Friday from 8-45 to 5-00pm.

The practice owner is registered with the Care Quality Commission (CQC) as an individual. 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. The practice manager is currently applying to be the registered manager.

During the inspection we received feedback from four patients. The patients were positive about the care and treatment they received at the practice. Comments included everything was explained well, they were made to feel at ease and they felt listened to.

Our key findings were:

  • The practice was visibly clean and uncluttered.
  • The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
  • Staff were qualified and had received training appropriate to their roles.
  • Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
  • Dental care records showed treatment was planned in line with current best practice guidelines.
  • Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
  • We observed patients were treated with kindness and respect by staff.
  • The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
  • Patients were able to make routine and emergency appointments when needed.
  • The governance systems were effective.

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

  • Review the storage of glucagon to ensure it is in line with the manufacturer’s guidance.
  • Review the practice’s infection control procedures and protocols giving due regard to 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 practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
Inspection areas

Safe

No action required

Updated 14 November 2016

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

Staff told us they felt confident about reporting incidents, accidents and the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).

Staff had received training in safeguarding at the appropriate level and knew the signs of abuse and who to report them to.

Staff were suitably qualified for their roles and the practice had undertaken the relevant recruitment checks to ensure patient safety.

Patients’ medical histories were obtained before any treatment took place. The dentists were aware of any health or medication issues which could affect the planning of treatment. Staff were trained to deal with medical emergencies. All emergency equipment and medicines were in date and in accordance with the British National Formulary (BNF) and Resuscitation Council UK guidelines. We noted the glucagon was not stored in the fridge and the practice had not reduced the expiry date accordingly.

X-ray equipment was serviced in line with the manufacturer’s guidance. Local rules were available within the surgery. We noted X-rays were not always justified in the dental care records.

The decontamination procedures were effective and the equipment involved in the decontamination process was regularly serviced, validated and checked to ensure it was safe to use. We noted the protein residue test was only completed on a monthly basis. This should be completed on a weekly basis. Data from the autoclave was sporadically downloaded. This should be done on a weekly basis and recorded.

Effective

No action required

Updated 14 November 2016

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

Patients’ dental care records provided comprehensive information about their current dental needs and past treatment. The practice monitored any changes to the patient’s oral health and provided treatment when appropriate.

The practice followed best practice guidelines when delivering dental care. These included Faculty of General Dental Practice (FGDP), National Institute for Health and Care Excellence (NICE) and guidance from the British Society of Periodontology (BSP).

The practice focused strongly on prevention and the dentists were aware of ‘The Delivering Better Oral Health’ toolkit (DBOH) with regards to fluoride application and oral hygiene advice.

Staff were encouraged to complete training relevant to their roles and this was monitored by the practice manager. The clinical staff were up to date with their continuing professional development (CPD).

Referrals were made to secondary care services if the treatment required was not provided by the practice.

Caring

No action required

Updated 14 November 2016

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

During the inspection we received feedback from four patients. Patients commented staff were helpful and polite. Patients also commented everything was explained well, they were made to feel at ease and were listened to.

We observed the staff to be welcoming and caring towards the patients.

We observed privacy and confidentiality were maintained for patients using the service on the day of the inspection.

Responsive

No action required

Updated 14 November 2016

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

The practice had an efficient appointment system in place to respond to patients’ needs. There were vacant appointments slots for urgent or emergency appointments. There were clear instructions for patients requiring urgent care when the practice was closed.

There was a procedure in place for responding to patients’ complaints. This involved acknowledging, investigating and responding to individual complaints or concerns. Staff were familiar with the complaints procedure.

The practice was fully accessible for patients in a wheelchair or with limited mobility to access treatment.

Well-led

No action required

Updated 14 November 2016

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

There was a clearly defined management structure in place and staff felt supported and appreciated in their own particular roles. The practice manager was responsible for the day to day running of the practice. The practice owners were the clinical leads within the practice.

Information was shared both informally through day to day interactions with staff and by practice meetings. The practice manager kept a log of what had been discussed at the informal meetings.

The practice regularly audited clinical and non-clinical areas as part of a system of continuous improvement and learning.

They conducted patient satisfaction surveys and were currently undertaking the NHS Friends and Family Test (FFT).