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Inspection Summary


Overall summary & rating

Updated 14 January 2016

We carried out an announced comprehensive inspection on 1 December 2015 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

Glumangate dental practice is situated over three floors of premises close to Chesterfield town centre. The ground and first floor are accessible to patients. The practice was registered with the Care Quality Commission (CQC) in October 2011. The practice provides regulated dental services to patients in the Chesterfield area of north Derbyshire. The practice provides both NHS and private dental treatment, with approximately 70% being NHS patients. Services provided include general dentistry, dental hygiene, teeth whitening, crowns and bridges, and root canal treatment.

The practice is open Mondays: 9:00 am to 5:45 pm; Tuesdays: 9:00 am to 5:00 pm; Wednesdays: 9:00 am to 5:00 pm; Thursdays: 9:00 am to 5:15 pm and Fridays: 9:00 am to 5:00 pm. The practice is closed at the weekend. Access for urgent treatment outside of opening hours is by ringing the practice and following the instructions on the recorded message.

The practice has seven dentists, although not all work full time, one dental hygienist and six dental nurses who also work on reception. There is one trainee dental nurse at the practice.

We received very positive feedback from 37 patients about the services provided. Patients expressed satisfaction with the whole service from reception to the dentist’s chair. Three patients said they had been seen quickly in an emergency, and one had a quick referral to the hospital for suspected cancer. Nearly half of the patients who provided feedback referred to being put at ease and helped to overcome their fear and anxiety. We received specific feedback requesting grab rails at the front door to help with negotiating the step into the practice.

Our key findings were:

  • The practice had systems and processes to record accidents, significant events and complaints.
  • Learning from any complaints and significant incidents was recorded and learning was shared with staff.
  • When necessary apologies were given to patients when things had gone wrong.
  • All staff had received whistle blowing training and were aware of these procedures and how to use them.
  • Patients spoke very positively about the dental service they received, and several recounted positive experiences they had had at the practice.
  • Patients said they were treated with dignity and respect, from the reception desk through to seeing the dentist.
  • Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Staff had been trained to deal with medical emergencies.
  • Emergency medicines, an automated external defibrillator (AED), and oxygen were readily available. An AED is a portable electronic device that automatically diagnoses life threatening irregularities of the heart and delivers an electrical shock to attempt to restore a normal heart rhythm.
  • The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
  • Patients’ care and treatment was planned and delivered in line with National Institute for Health and Care Excellence (NICE) guidelines.
  • Patients said they were involved in making decisions about their treatment, and records in the practice supported this view.
  • Options for treatment were identified and explored and discussed with patients.
  • Patients’ confidentiality was maintained.

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

  • Review and update the Legionella risk assessment at the practice.
  • As part of the Legionella risk assessment, hot water taps should be run on a regular basis and water temperatures recorded.
  • Change the waste bin in decontamination room to a hands free, foot pedal design to reduce the infection control risks.
  • Re-organise the storage of mops in the cleaning cupboard, so they do not pose a risk of cross infection.
Inspection areas

Safe

No action required

Updated 14 January 2016

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

The practice recorded any accidents and significant events and learning points were shared with staff in team meetings.

The practice received Medicines and Healthcare products Regulatory Agency (MHRA) alerts and took appropriate action including sharing information with staff.

Staff had been trained in safeguarding vulnerable adults and children. There were clear guidelines for reporting concerns and the practice had a lead member of staff to offer support and guidance over safeguarding matters.

The practice had the necessary emergency equipment including an automated external defibrillator (AED) and oxygen. An AED is a portable electronic device that automatically diagnoses life threatening irregularities of the heart and delivers an electrical shock to attempt to restore a normal heart rhythm.

Recruitment checks were completed on all new members of staff. This was to ensure staff were suitable and appropriately qualified and experienced to carry out their role.

Infection control procedures followed published guidance to ensure that patients were protected from potential risks.

Equipment used in the decontamination process was maintained by a specialist company and regular frequent checks were carried out to ensure equipment was working properly and safely.

X-rays were carried out safely in line with published guidance, and X-ray equipment was regularly serviced to make sure it was safe for use.

Effective

No action required

Updated 14 January 2016

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

Patients were clinically assessed by a dental professional before any treatment began. This included completing a health questionnaire or updating one for returning patients who had previously completed a health questionnaire. The practice used a recognised assessment process to identify any potential areas of concern in patients’ mouths.

The practice was following National Institute for Health and Care Excellence (NICE) guidelines for the care and treatment of dental patients. Particularly in respect of recalls, wisdom tooth removal and the use of antibiotics.

The practice had sufficient numbers of qualified and experienced staff to meet patients’ needs.

There were clear procedures for referring patients to secondary care (hospital or other dental professionals). Staff were able to demonstrate that referrals had been made in a timely way when necessary.

Caring

No action required

Updated 14 January 2016

We found that this practice was providing caring services in accordance with

the relevant regulations.

Staff were aware of the need for confidentiality, and took steps to ensure patients’ confidentiality. This was both in the practice with the patients, and with regard to record keeping.

Patients were treated with dignity and respect.

Staff at the practice were welcoming to patients and made efforts to help patients relax.

Patients said they received very good dental treatment and they were involved in discussions about their dental care.

Patients said they were able to express their views and opinions.

Responsive

No action required

Updated 14 January 2016

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

The practice had an appointments system which patients said was accessible and met their needs. The appointments system included a text message reminder service. Patients who were in pain or in need of urgent treatment were usually seen the same day.

The practice had ground floor treatment rooms, so that patients with restricted mobility could access the practice and receive treatment.

There were arrangements for emergency dental treatment outside of normal working hours, including weekends and public holidays which were clearly displayed in the waiting room, and the practice leaflet.

There were systems for patients to make formal complaints, and these were acted upon, and apologies given when necessary.

Well-led

No action required

Updated 14 January 2016

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

There was a clear management structure at the practice, and staff were aware of their roles and responsibilities.

The practice was carrying out audits of both clinical and non-clinical areas to assess the safety and effectiveness of the services provided.

Patients were able to express their views and comments, and the practice listened to those views and acted upon them.

Staff said the practice was a friendly place to work, and they could speak with the practice manager or a dentist if they had any concerns.