Archived: J.T. Johnston Dental Practice

Updated 12 May 2016

This was an announced inspection and was carried out on 22 March 2016. The inspection was led by a CQC inspector and a dental specialist advisor.

We informed NHS England area team and local Healthwatch that we were inspecting the practice; however we did not receive any information of concern from them.

The methods that were used to collect information at the inspection included interviewing staff, observations and reviewing documents.

During the inspection we spoke with both the dentist and the dental nurse/receptionist. We looked around the premises reviewed policies, dental care records, staff files and other records relating to the management of the service. We reviewed 4 completed CQC comment cards.

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 12 May 2016

We carried out an announced comprehensive inspection on 22 March 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

J.T. Johnston Dental Practice is a mixed dental practice providing both NHS and private treatment. The practice caters for children and adults and is situated in Tunbridge Wells, Kent. The practice provides services from one room within a building where other services are provided. The reception area is integrated into the one room practice. There is a waiting area which is shared with other services provided in the building. The practice has one dentist and one dental nurse who has a dual role as receptionist. Dental services are provided Monday to Friday from 9am to 12(noon) and from 1pm to 5pm. Out of hours emergency services are provided by Dentaline.

CQC inspected the practice on 2 July 2013 and although the provider met the five outcomes inspected CQC did ask the provider to make improvements regarding the decontamination and sterilization procedure to ensure a separate hand wash sink and the provision of both dirty and clean areas. We checked these areas as part of this comprehensive inspection and found this had been resolved.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

We received feedback from patients about the service via four Care Quality Commission (CQC) comment cards however there were no patients available to speak with during the inspection. All the comments were positive about the staff and the services provided. Patients indicated that they were happy with the dental care and treatment that they had received, that their needs were met and that they were treated with dignity and respect.

Our key findings were:

• The practice was visibly clean, comfortable and well maintained.
• Patients’ needs were assessed and care and treatment was planned and delivered in line with current guidance.
• The practice had clear safeguarding processes and staff were trained and understood their responsibilities for safeguarding children and vulnerable adults.
• Staff understood their responsibilities to raise concerns and to record safety incidents and to report these internally and externally where appropriate.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Staff had received appropriate training for their role and were proactive in ensuring they achieved their continuing professional development (CPD).
• There was an effective complaints system
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to manage medical emergencies.
• The practice had suitable emergency equipment. However the practice did not have access to an automated external defibrillator, but was carrying out research prior to purchase.
• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients could access routine treatment and urgent care when required.

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

• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance
• Review the practice’s audit protocols of various aspects of the service, such as radiography and dental care records at regular intervals to help improve the quality of service. The practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.
• Review the practices process to ensure there is an effective system for gaining and recording written consent in a consistent manner.