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Inspection Summary


Overall summary & rating

Updated 31 January 2018

We carried out this announced inspection on 9 January 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.

We told the NHS England Cheshire and Merseyside area team that we were inspecting the practice. We did not receive any information of concern from them.

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

Smithdown Dental Practice is situated in a suburb of Liverpool and provides dental care and treatment to adults and children on an NHS and privately funded basis.

The provider has a portable ramp available to facilitate access to the practice for wheelchair users. The practice has three treatment rooms. Car parking is available near the practice.

The dental team includes a principal dentist, three associate dentists and eight dental nurses, three of whom also carry out reception duties, and four of whom are trainees. The team is supported by a practice manager.

The practice is owned by an individual who is the principal dentist there. They 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 25 people about the services provided. The feedback provided was positive about the practice.

During the inspection we spoke to two dentists, five dental nurses and the practice manager. We looked at practice policies, procedures and other records about how the service is managed.

The practice is open:

Monday and Tuesday 9.00am to 6.00pm

Wednesday 9.00am to 5.30pm

Thursday 9.00am to 5.00pm

Friday 9.00am to 3.30pm.

Our key findings were:

  • The practice was clean and well maintained.
  • The practice had infection control procedures in place which reflected published guidance.
  • Safeguarding processes were in place and staff knew their responsibilities for safeguarding adults and children.
  • Staff provided patients’ care and treatment in line with current guidelines.
  • The practice had a procedure in place for dealing with complaints.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
  • The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
  • The practice asked patients and staff for feedback about the services they provided.
  • Staff knew how to deal with emergencies. We observed that two sizes of oro-pharyngeal airway and a child size self-inflating resuscitation bag were not available.
  • The practice had systems in place to help them manage risk. Not all risks from sharp instruments had been assessed and reduced.
  • The practice had staff recruitment procedures in place. We found that the practice did not request employment histories or references for all staff prior to employment.

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

  • Review the availability of equipment to manage medical emergencies taking account of the guidelines issued by the Resuscitation Council (UK), and the General Dental Council.
  • Review the practice's recruitment policy and procedures to ensure character references for new staff as well as employment histories are requested and recorded suitably.
  • Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities, specifically in relation to staff immunity status to Hepatitis B, and to sharps.
  • Review the practice’s protocols in relation to the use of closed circuit television to ensure staff and patients are fully informed as to its purpose and their right to access footage containing their images.
Inspection areas

Safe

No action required

Updated 31 January 2018

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

The practice had systems and processes in place to provide safe care and treatment. They used learning from incidents to help them improve.

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

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

We found that the practice had arrangements in place for the use of X-rays.

Staff were qualified for their roles, where relevant. The practice completed some essential recruitment checks before employing staff. We found the practice had not requested references or employment histories for some recently recruited staff.

The practice had suitable arrangements for dealing with medical and other emergencies. We observed that two sizes of oro-pharyngeal airway and a child size self-inflating resuscitation bag were not available.

The practice had procedures in place to manage and reduce risks. We saw that the practice had put in place all reasonably practicable measures to reduce the risks, with the exception of risks in relation to some sharp instruments, and staff immunity to the Hepatitis B vaccination.

Effective

No action required

Updated 31 January 2018

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

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as thorough. 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.

We observed that staff had provided a targeted dental health promotion and prevention ‘caries awareness’ programme for their six to eight year old patients where a particular need had been identified for this.

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

The practice used closed circuit television for monitoring the waiting and reception areas in the practice but were not displaying sufficient information about this.

Caring

No action required

Updated 31 January 2018

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

the relevant regulations.

Patients were positive about all aspects of the service. They told us staff were polite, attentive and professional. They said that they were given helpful explanations about dental treatment, and said their dentists were understanding and listened to them.

Patients commented that staff 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 31 January 2018

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

The practice’s appointment system took account of patients’ needs. Patients could obtain an appointment quickly in an emergency.

Staff considered patients’ individual needs and made reasonable adjustments to meet these. This included providing facilities for patients with disabilities. The practice had access to interpreter services and had arrangements in place to help patients with sight or hearing loss.

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

Well-led

No action required

Updated 31 January 2018

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

The practice had arrangements in place to ensure the smooth running of the service. These included systems for the practice team to review the quality and safety of the care and treatment provided.

There was a clearly defined management structure and staff felt supported and appreciated.

Staff were aware of the importance of confidentiality and protecting patients’ personal information The practice team kept accurate patient dental care records which were 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.