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Inspection Summary


Overall summary & rating

Updated 19 December 2018

We carried out this announced inspection on 7 November 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 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

Newton Dental is in a suburb of Newton-le-Willows and provides NHS and private dental care for adults and children.

The provider has installed a ramp to facilitate access to the practice for wheelchair users and for pushchairs. Car parking is available near the practice.

The dental team includes a principal dentist, four associate dentists, two dental hygiene therapists, eight dental nurses, one of whom was a trainee, and a reception supervisor. The dental team is supported by a practice manager. The practice has five treatment rooms.

The practice is owned by company 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 Newton Dental was the practice manager.

We received feedback from 42 people during the inspection about the services provided. The feedback provided was positive.

During the inspection we spoke to dentists, dental nurses, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Wednesday, Thursday 9.00am to 6.00pm

Tuesday 9.00am to 8.00pm

Friday 9.00am to 3.00pm

Saturday 9.00am to 2.00pm.

Our key findings were:

  • The practice was clean and well maintained.
  • The practice had infection control procedures in place which reflected published guidance.
  • The provider had safeguarding procedures in place and staff knew their responsibilities for safeguarding adults and children.
  • Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available. Insufficient medical emergency oxygen was available at the practice.
  • Staff provided patients’ care and treatment in line with current guidelines.
  • The dental team provided preventive care and supported patients to achieve better oral health.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system took account of patients’ needs.
  • The provider had a procedure in place for dealing with complaints. The practice dealt with complaints positively and efficiently.
  • The practice had a leadership and management structure.
  • The provider had systems in place to manage risk.
  • Staff felt involved and supported and worked well as a team.
  • The practice asked patients and staff for feedback about the services they provided.

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

  • Review the practice's protocols and procedures to ensure compliance with the Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment, specifically to ensure all dentists consistently justify and report on X-rays taken.
  • Review the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council, specifically in relation to ensuring sufficient medical emergency oxygen is available.
  • Review the arrangements for ensuring the practice’s systems for monitoring the quality and safety of the service are effective, in particular in relation to auditing, and to the monitoring of accident records.
Inspection areas

Safe

No action required

Updated 19 December 2018

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

The provider had systems and processes in place to provide safe care and treatment.

Staff received training in safeguarding and knew how to report concerns.

Staff were qualified for their roles, where relevant.

The provider completed essential recruitment checks before employing staff.

The premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had arrangements for dealing with medical and other emergencies. Insufficient medical emergency oxygen was available. The provider assured us this would be addressed.

The practice had systems in place for the safe use of X-rays. Not all the dentists were consistently justifying and reporting on X-rays taken.

Effective

No action required

Updated 19 December 2018

We found that this practice was providing effective care in accordance with

the relevant regulations.

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as superb

. The dentists discussed treatment with patients so they could give informed consent and recorded this in their records.

The practice had clear arrangements for referring patients to other dental or health care professionals.

The provider supported staff to complete training relevant to their roles and had systems to monitor this.

Several staff had additional qualifications or had undertaken further training to enhance their existing skills or provide them with new skills.

The practice had systems in place in relation to the safe provision of sedation and followed recognised guidance.

Caring

No action required

Updated 19 December 2018

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

We received feedback about the practice from 42 people. Patients were positive about all aspects of the service the practice provided. They told us staff were helpful, polite and have the patient’s welfare as a priority.

They said they were given thorough and full explanations about dental treatment, and said their dentist listened to them.

Patients commented that staff made them feel at ease, especially when they were anxious about visiting the dentist.

Staff protected patients’ privacy and were aware of the importance of confidentiality.

Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 19 December 2018

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

The practice’s appointment system took account of patients’ needs. Patients could book an appointment quickly if in pain.

Staff considered patients’ differing needs and put measures in place to help all patients receive care and treatment. This included providing facilities for patients with disabilities and families with children.

The practice had access to interpreter services and had arrangements to assist patients who had sight or hearing loss.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 19 December 2018

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

There was a clearly defined management structure and staff felt supported and appreciated.

The practice team kept accurate, complete patient dental care records.

The provider had arrangements in place to ensure the smooth running of the service. These included systems for the practice team to monitor the quality and safety of the care and treatment provided. Monitoring was not always carried out appropriately, for example, monitoring of accident recording was not carried out.

The practice team asked for and listened to the views of patients.

The practice had procedures in place to manage and reduce risks. We saw that the practice had put in place measures to reduce the risks identified in the assessments.