1-5 Orchard Road

Updated 10 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We carried out an announced, comprehensive inspection on 28 January 2016. The inspection was carried out by a CQC inspector and a dental specialist advisor. Prior to the inspection we reviewed information submitted by the provider.

During our inspection visit, we reviewed policy documents and staff records. We spoke with six members of staff, which included two dentists, three dental nurses and the practice manager. We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. We reviewed the practice’s decontamination procedures of dental instruments and also observed staff interacting with patients in the waiting area. We also reviewed 21 CQC comment cards completed by patients in the two-week period prior to our inspection visit.

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 therefore formed the framework for the areas we looked at during the inspection

Updated 10 March 2016

We carried out an announced comprehensive inspection on 28 January 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.

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

1-5 Orchard Road is located in the London Borough of Barking and Dagenham and provides NHS and private dental treatment to both adults and children. The premises are on the ground floor and consist of four surgeries, a reception area and a dedicated decontamination room. The premises are wheelchair accessible and have facilities for wheelchair users. The practice is open Monday to Friday 8:30am – 5:00pm.

The staff consists of three associate dentists, three dental nurses, two trainee dental nurses who also undertook the role of receptionists and a practice manager.

The dental executive is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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 21 Care Quality Commission (CQC) comment cards completed by patients. Patients who completed the comment cards were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor

Our key findings were:

• Patients were involved in their care and treatment planning so they could make informed decisions.

• There were effective processes in place to reduce and minimise the risk and spread of infection.

• Equipment to manage medical emergencies such as oxygen was readily available. Staff knew where the equipment was stored.

• There were systems in place to check equipment including the autoclave, oxygen cylinder and the X-ray equipment had been serviced regularly.

• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• At our visit we observed staff were kind, caring and professional.

• There was a lack of effective processes for acknowledging, recording, investigating and responding to complaints made by patients.

• Suitable checks had not been undertaken before employing staff.

• There was a lack of an effective process to ensure staff were working towards completing the required number of continuing professional development hours to maintain their professional development in line with requirements set by the General Dental Council.
• The provider did not have efffective systems to monitor and improve quality, as was evident from lack of routine audits in key areas, such as radiography. Audits that had been undertaken lacked information and actions identified were not always carried out.

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

• Establish an effective process for acknowledging, recording, investigating and responding to complaints made by patients.

• Ensure audits of various aspects of the service, such as radiography, are undertaken at regular intervals to help improve the quality of service. The practice should also check, that where appropriate the audits have documented learning points and the resulting improvements can be demonstrated.

• Review the procedures and protocols to comply with relevant 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).