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Inspection Summary


Overall summary & rating

Updated 21 April 2017

We carried out an announced comprehensive inspection on 9 December 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

Nuffield House Dental Practice is situated within purpose adapted premises in Harlow, Essex. The practice has four treatment rooms and a combined waiting room and reception area. Decontamination takes place within a dedicated decontamination room (Decontamination is the process by which dirty and contaminated instruments are bought from the treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

The practice offers predominantly NHS and some private general and cosmetic dental treatments to adults and children.

The practice is registered with the Care Quality Commission (CQC) as an organisation. The principal dentist is the ‘registered manager’. 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.

In addition to the principal dentist, three associate dentists and six dental nurses work at the dental practice. The dental team are supported by two part time dental hygienists.

The practice is open and appointments are available from 9am to 5.30pm Mondays to Thursdays and between 8am and 4pm on Fridays.

We received feedback from 39 patients who completed CQC comment cards prior to our inspection visit. We also spoke with four patients during the inspection visit. Patients made positive comments about the quality of the dental care and treatment that they received. They also commented positively about the cleanliness of the premises, the friendliness and helpfulness of staff. Patients said that the dentists explained treatment plans to them in a way that they could easily understand. Patients told us that the dentists were kind and understanding particularly when treating anxious or nervous patients.

Our key findings were:

  • The practice had systems in place for investigating and learning from complaints, safety incidents and accidents. Staff were aware of their responsibilities to report incidents.
  • The practice was visibly clean and clutter free. Infection control practices were reviewed and audited to test their effectiveness.
  • There were systems in place to help keep people safe, including safeguarding vulnerable children and adults. Staff had undertaken training and were aware of their roles and responsibilities in relation to this.
  • Risks to the health, welfare and safety of patients and staff were regularly assessed and managed. These included risks in relation to fire, legionella and risks associated with premises and equipment.
  • The practice reviewed and followed guidance in relation to dentistry.
  • The practice had the recommended medicines and equipment for use in the event of a medical emergency and staff were trained in their use. Records were maintained in respect of the checks carried out for these medicines and equipment.
  • Staff were recruited robustly, supported, supervised and undertook training in respect of their roles and responsibilities within the practice.
  • Patients reported that they were treated with respect and that staff were polite and helpful.
  • Patients were involved in making decisions about their care and treatments.
  • Effective governance arrangements were in place for the smooth running of the service.
  • Audits and reviews were carried out to monitor and improve services. Learning from audits and reviews was shared with relevant staff and action plans were developed to secure improvements where these were identified.
  • Patient’s views were sought and these were used to make improvements to the service where these were identified.

Inspection areas

Safe

No action required

Updated 21 April 2017

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, and to assess and minimise risks. Audits and reviews were carried out to assess and monitor potential risks to patients and staff. Accidents, safety incidents and complaints were monitored and investigated. The results from these were shared with staff and learning acted upon to improve safety within the practice

The practice had procedures in place to safeguard children and vulnerable adults. Staff had access to these procedures and undertook role specific training in safeguarding and their responsibilities to keeping people safe. There was an appointed safeguarding lead identified to oversee and monitor the safeguarding procedures. Staff who we spoke with understood their responsibilities in this area.

The practice was visibly clean and infection control procedures were in place to minimise the risks to patients and staff. The cleaning and decontamination of dental instruments was carried out in line with current guidelines.

Equipment within the practice was regularly checked, serviced and maintained according to the manufacturer’s instructions. The practice had the recommended range of equipment and medicines for use in medical emergencies and staff undertook regular training updates in basic life support.

New staff were appropriately recruited in line with the practice recruitment procedures.

Effective

No action required

Updated 21 April 2017

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

The referred to and followed current relevant guidance in the assessment and treatment of patients. The dental care provided was monitored to ensure that it was evidence based and focussed on the needs of the patients.

Patient’s medical history was obtained and reviewed to help the dentists identify any risks to patients. Oral assessments were carried out in line with current guidance and appropriate advice was provided to promote patients oral health. Dental care records were of good quality and showed that patients were recalled in line with national guidance, and were screened appropriately for gum disease and oral cancer.

Patients were offered options of treatments available and were advised of the associated risks and intended benefits. Consent to care and treatment was sought in line with current relevant guidelines.

Patients were referred to other specialist services where appropriate and in a timely manner.

Staff had the skills, knowledge and experience to deliver effective care and treatment.

Caring

No action required

Updated 21 April 2017

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

The practice had procedures in place for respecting patients’ privacy, dignity and providing compassionate care and treatment. Staff had access to these procedures and were aware of their responsibilities in relation to these.

A private room was available should patients wish to speak confidentially with the dentist or reception staff. Staff had access to policies around respecting and promoting equality and diversity.

The practice had procedures to assist patients to be involved in making decisions about their dental care and treatment.

The patients who we spoke with and those who completed CQC surveys said that they were treated with respect and kindness by staff. They said that they were provided with sufficient information and were involved in making decisions about their dental care and treatment.

The practice had procedures to assist patients to be involved in making decisions about their dental care and treatment.

Responsive

No action required

Updated 21 April 2017

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

The practice was open and appointments were available from 9am to 5.30pm Mondays to Thursdays and between 8am and 4pm on Fridays.

The practice had considered the needs of patients who may require additional support and had made reasonable adjustments to the premises to meet these needs.

The practice had a complaints process which was available to support any patients who wished to make a complaint. The process described the timescales involved for responding to a complaint and who was responsible in the practice for managing them.

Complaints were investigated and responded to in a timely way and patients were provided with an apology and an explanation as appropriate. Complaints and learning arising from the investigation of these were discussed during practice meetings to help improve patients’ experiences.

Well-led

No action required

Updated 21 April 2017

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

There were governance arrangements and leadership within the practice to ensure that appropriate systems were in place to monitor and improve the quality and safety of services.

The practice had systems in place to carry out regular audits to monitor areas including health and safety, fire safety, infection control and staff training and development. Regular audits were carried out to ensure that dental treatments were carried out in line with the relevant guidance and to make improvements as needed.

There were arrangements in place to ensure that training was accessible to staff. Learning and development needs of staff were reviewed at appropriate intervals and staff received appropriate appraisal or supervision.

The practice had systems to obtain and act on feedback from patients and staff and used this to improve the quality of the service provided.