Archived: Alan Ribbons Dental Surgery

We carried out this announced inspection on 31 July 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. We had also received several complaints about the practice. 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 this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was not providing effective care in accordance with the relevant regulations.

Are services caring?

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

Are services responsive?

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

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Alan Ribbons Dental Surgery is based in Taverham and offers private treatment to approximately 3,000 patients. There is portable ramp access for people who use wheelchairs and those with pushchairs. The dental team is small and consists of one dentist and one dental nurse, who are a husband and wife. There is one treatment room.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 20 CQC comment cards filled in by patients and spoke with four other patients.

During the inspection we spoke with the dentist and the nurse. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice had suitable safeguarding processes and staff knew their responsibilities for protecting adults and children.

• Staff treated patients with dignity and respect, and we received many positive comments from patients about the caring and empathetic nature of both the dentist and nurse.

• Patients received their care and treatment from staff who enjoyed their work.

• The appointment system met patients’ needs and patients found it easy to access emergency and out of hours dental care.

• Patients’ dental care was not always delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• Dental care records were not maintained in line with guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

• Medicines were not managed or prescribed according to national guidance.

• The practice’s infection control procedures did not comply with national guidance.

• The practice did not have a structured plan in place to audit quality and safety beyond an audit for infection control.

We identified regulations the provider was not meeting. They must:

• Ensure care and treatment is provided in a safe way to patients
• Ensure the care and treatment of patients is appropriate, meets their needs and reflects their preferences
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.