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Archived: City Dental Practice

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Inspection Summary


Overall summary & rating

Updated 11 February 2016

We carried out an announced comprehensive inspection on 8 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

City Dental Practice is situated on the first floor of premises in Nottingham city centre. The practice is not accessible to patients with restricted mobility, such as those who use a wheelchair, as there is no lift available. The practice was registered with the Care Quality Commission (CQC) in December 2011. The practice provides regulated dental services to patients in Nottingham. The practice provides both NHS and private dental treatment, with approximately 60% being NHS patients. Services provided include general dentistry, dental hygiene, teeth whitening, crowns and bridges, and root canal treatment.

The practice is open Mondays to Thursdays: 9:00 am to 5:00 pm; and Fridays: 9:00 am to 4:30 pm. The practice is closed at the weekend. Access for urgent treatment outside of opening hours is by ringing the practice telephone number and following the answerphone message. Alternatively patients could ring 111 and contact the NHS out-of-hours service.

The practice has two dentists, one dental hygienist, five dental nurses and two receptionists.

We received positive feedback from 49 patients about the services provided. Patients said the reception staff were friendly, welcoming and put them at their ease, patients also expressed satisfaction with the quality of dental care they received from their dentist. Many patients had been coming to the practice for a number of years, and had total confidence in the dentists and the practice as a whole.

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 discussions showed staff were aware of these procedures and how to use them.
  • Patients spoke very positively about the dental service they received, and several gave examples of 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:

  • Update the practice website to make it clear the practice is not fully accessible to patients with restricted mobility.
Inspection areas

Safe

No action required

Updated 11 February 2016

The practice had systems and processes to record any accidents and significant events and learning points were shared with staff. 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 11 February 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 11 February 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 11 February 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.

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 11 February 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. There was a practice manager to organise and manage the day to day events in the practice.

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.