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Inspection Summary


Overall summary & rating

Updated 15 November 2016

We carried out an announced comprehensive inspection on 22 September 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

Aldridge Dental Practice is a dental practice providing general dental services on a NHS and private basis. The service is provided by five dentists. They are supported by five dental nurses (three of whom are trainees), a practice manager and two receptionists. A sixth dentist visits the practice on a monthly basis to provide dental implants and other oral surgery procedures.

The practice is located on a main road near local amenities and bus routes. There is wheelchair access to the practice and car parking facilities. The premises consist of a waiting room, a reception area, an office, four treatment rooms, two decontamination rooms, a staff room, an X-ray room, storage rooms and toilet facilities for patients with disabilities. Opening hours are from 8am to 8pm every Wednesday and from 8:30am to 5:30pm on all other weekdays.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. 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.

Fourteen patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with three patients. The information from patients was generally complimentary. Patients were positive about their experience and they commented that staff were friendly and caring.

Our key findings were:

  • The practice was organised and appeared clean and tidy on the day of our visit. Many patients also commented that this was their experience.
  • Patients told us they found the staff polite and friendly.
  • An infection prevention and control policy was in place. We saw the decontamination procedures followed recommended guidance.
  • Dental professionals provided treatment in accordance with current professional guidelines.
  • Staff received training appropriate to their roles.
  • There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
  • The practice had a complaints system in place and there was an openness and transparency in how these were dealt with. Documentation of complaints required improvements.
  • Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
  • Practice meetings were used for shared learning.
  • The practice demonstrated that they regularly undertook audits in infection control, radiography and dental care record keeping; however, the infection control audits were not being carried out every six months as per guidance.
  • The practice had systems to assess and manage risks to patients, including health and safety, safeguarding, safe staff recruitment and the management of medical emergencies. Some of these required improvements.
  • Patients were able to make routine and emergency appointments when needed; however, some patients commented they had to wait lengthy periods before getting an appointment at their preferred time.

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

  • Review the practice’s arrangements for receiving and responding to 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), as well as from other relevant bodies such as Public Health England (PHE).

  • Review availability of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team. These should extend to domiciliary visits too. The practice should review stocks of medicines and equipment and the system for identifying and disposing of expired stock.

  • Review the practice’s audit protocols of various aspects of the service such as infection control at regular intervals to help improve the quality of service.
  • Review the practice’s procedures for documenting safeguarding incidents and complaints to ensure that all are recorded in sufficient detail.

Inspection areas

Safe

No action required

Updated 15 November 2016

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

The practice had systems to assess and manage risks to patients. These included whistleblowing, complaints, safeguarding and the management of medical emergencies. It also had a recruitment process to help ensure the safe recruitment of staff. We identified some necessary improvements on the day of our visit.

Patients’ medical histories were obtained before any treatment took place. The dentist was aware of any health or medicines issues which could affect the planning of treatment. Staff were trained to deal with medical emergencies. Emergency equipment and medicines were available and in accordance with the British National Formulary (BNF) and Resuscitation Council UK guidelines. These arrangements did not extend to domiciliary visits.

The practice was carrying out infection control procedures as described in the ‘Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary dental practices’.

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

Effective

No action required

Updated 15 November 2016

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

The practice monitored any changes to the patients’ oral health and made referrals for specialist treatment or investigations where indicated. Explanations were given to patients in a way they understood and risks, benefits and options were explained. Record keeping was in line with guidance issued by the Faculty of General Dental Practice (FGDP).

The dentists followed national guidelines when delivering dental care. These included FGDP and National Institute for Health and Care Excellence (NICE). We found that preventative advice was given to patients in line with the guidance issued in the Department of Health publication 'Delivering better oral health: an evidence-based toolkit for prevention' when providing preventive oral health care and advice to patients. This is an evidence based toolkit used by dental teams for the prevention of dental disease in a primary and secondary care setting.

Caring

No action required

Updated 15 November 2016

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

On the day of the inspection we observed privacy and confidentiality were maintained for patients using the service. Patient feedback was mostly positive about the care they received from the practice. Patients described staff as friendly and polite. Patients commented they felt involved in their treatment and it was fully explained to them. Nervous patients said they felt at ease here and the staff were supportive and understanding. Several patients commented that the practice was child-friendly.

Responsive

No action required

Updated 15 November 2016

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

The practice was usually able to accommodate patients requiring urgent treatment within 24 hours. Patients were able to obtain information when the practice was closed and arrangements were subsequently made for these patients requiring emergency dental care.

The practice had a complaints process.

The practice offered access for patients with limited mobility.

Well-led

No action required

Updated 15 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 we spoke with felt supported in their own particular roles.

There were systems in place to monitor the quality of the service including various audits. The practice used several methods to successfully gain feedback from patients. Staff meetings took place on a regular basis.

The practice carried out audits such as radiography and dental care record keeping at regular intervals to help improve the quality of service. Infection control audits were carried out annually but these are recommended every six months. All audits had documented learning points with action plans.