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Inspection Summary


Overall summary & rating

Updated 11 December 2019

We carried out this announced inspection on 26 November 2019 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 this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

The Dentist, Buntingford is a well-established practice that offers private treatment to about 3500 patients. The dental team consists of a dentist, a dental nurse, two hygienists and a receptionist. There are three treatment rooms. The practice opens on Mondays to Thursdays from 9 am to 6pm pm, and on Fridays from 9 am to 1 pm. There is portable ramp access for wheelchair users and a public car park close by.

The practice is owned by an individual who is the dentist there. He has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 50 CQC comment cards filled in by patients and spoke with another two.

During the inspection we spoke with the dentist, the nurse and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

  • Staff treated patients with care, dignity and respect. We received many positive comments from patients about the caring and empathetic nature of staff and the effectiveness of their treatment.

  • The practice was small and friendly, something which patients appreciated.

  • The dentist dealt with complaints empathetically and efficiently.

  • The appointment system took account of patients’ needs.

  • The practice had cone beam computed tomography scanner, a Cerec machine, (to make ceramic dental restorations), an intra-oral camera and its own on-site milling machine to enhance the delivery of care to patients.

  • Staff recruitment procedures were not robust, and staff had been employed without appropriate checks having been obtained.

  • Patient dental care records did not reflect standards set by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

  • The management of risk in the practice was limited and control measures to reduce potential hazards had not always been implemented.

  • Audit systems within the practice were limited and had not been used effectively to drive improvement.

We identified regulations the provider was not meeting. They must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider was not meeting are at the end of this report.

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

  • Review the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

  • Review the availability of an interpreter service for patients who do not speak English as their first language.

  • Review the practice's policies and procedures for obtaining patient consent to care and treatment to ensure they are in compliance with legislation, take into account relevant guidance.

  • Review the practice's processes and systems for seeking and learning from patient feedback with a view to monitoring and improving the quality of the service.
Inspection areas

Safe

Improvements required

Updated 11 December 2019


Effective

No action required

Updated 11 December 2019


Caring

No action required

Updated 11 December 2019


Responsive

No action required

Updated 11 December 2019


Well-led

Improvements required

Updated 11 December 2019