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Inspection Summary


Overall summary & rating

Updated 7 February 2019

We carried out this announced inspection on 18 December 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. 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

Glodwick Dental Centre is in Oldham and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces and additional on street parking is available near the practice.

The dental team includes five dentists and two foundation dentists, 12 dental nurses (three of which are trainees), a dental hygiene therapist. The clinical team is supported by a practice manager. The practice has six treatment rooms, three on the ground floor and three on the first floor.

The practice is owned by a 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 Glodwick Dental Centre is one of the principal dentists.

On the day of inspection, we collected 30 CQC comment cards filled in by patients. Patients were positive about all aspects of the service the practice provided.

During the inspection we spoke with four dentists, dental nurses, the dental hygiene therapist 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 & Thursday 08:00 to 12:00 and 13:00 to 17:00

Tuesday & Friday 09:00 to 13:00 and 14:00 to 18:00

Wednesday 08:00 to 13:00 and 14:00 to 18:00

Our key findings were:

  • The premises were 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 practice had systems to help them manage risk to patients and staff.
  • The practice staff 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.
  • The provider was providing preventive care and supporting patients to ensure better oral health.
  • The appointment system met patients’ needs.
  • The practice had effective leadership and culture of continuous improvement.
  • Staff felt involved and supported and worked well as a team.
  • The practice 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.

We identified areas of notable practice:

The registered provider had systems to review the general and oral health profile of the local population and target areas for improvement. Staff understood the needs of the local population, they planned and targeted their services to meet their needs and address inequalities. For example, alcohol-related harm, smoking and the use of betel nut. Patients were provided with oral health kits. The practice were forging close working relationships with other healthcare providers to support them with signposting patients and appropriate prescribing.

There was a proactive support system in place for staff to develop their knowledge and skills, and motivate them to provide a quality service. The team proactively participated in, and piloted projects to remove barriers to accessing dental care and encourage attendance. They forged links in the community with other healthcare providers, schools, nurseries and the local mosque to improve oral health in the locality.

They contributed to a local charity and provided toothbrushes and toothpaste to be included in Christmas welfare packages which were provided to homeless and disadvantaged people.

There was a healthy living champion in the practice who actively supported staff to create bespoke oral health displays. They used skills effectively in the practice to maximise preventative interventions. Bespoke information was created in other languages and for patients during periods of fasting. They recognised the need to remove barriers to care for dementia patients and during periods of fasting for patients. For example, they had adjusted the opening hours to provide a choice of early morning or later appointments. The team ensured that during periods of fasting, Muslim patients could access care and treatment at a time that did not impact on their fast or routine.

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

  • Review the practice's Legionella risk assessment and implement any recommended actions, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’

  • Review the practice’s 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.

  • Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
Inspection areas

Safe

No action required

Updated 7 February 2019

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

The practice had systems and processes to provide safe care and treatment. The process for documenting actions taken after incidents could be improved.

Staff received training in safeguarding people and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed essential recruitment checks.

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

The practice had suitable arrangements for dealing with medical and other emergencies.

There were systems to identify and manage risks. Improvements could be made to assess the risk from Legionella and ensure clinical staff have immunity to Hepatitis B.

Effective

No action required

Updated 7 February 2019

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

The staff were involved in quality improvement initiatives including primary care projects as part of their approach in providing high quality care. They engaged with the local community to give oral health advice and encourage attendance at dental appointments.

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as first class and exceptional. The dentists discussed treatment with patients so they could give informed consent and recorded this in their records.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

The practice supported staff to complete training relevant to their roles and had systems to help them monitor this.

The team were involved in quality improvement initiatives such as local oral health improvement projects as part of its approach in providing high quality care. They contributed to improving the oral health of the local community through raising awareness and oral health promotion.

Caring

No action required

Updated 7 February 2019

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

We received feedback about the practice from 30 people. Patients were positive about all aspects of the service the practice provided. They told us staff were friendly, professional and caring.

They said that they were given helpful, honest explanations about dental treatment, and said their dentist listened to them. Patients commented that they made them feel at ease, especially when they were anxious about visiting the dentist.

We saw that 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 7 February 2019

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

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. This included providing facilities for disabled patients and families with children. The practice had access to telephone and face to face interpreter services and had arrangements to help patients with sight or hearing loss.

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

Well-led

No action required

Updated 7 February 2019

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

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided. There was a clearly defined management structure and staff felt supported and appreciated.

They had systems to review the general and oral health profile of the local population and target areas for improvement. Staff understood the needs of the local population, they planned the services to meet their needs and address inequalities.

The practice team kept complete patient dental care records which were, clearly written or typed and stored securely.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.