Archived: The Dental Surgery

Updated 27 March 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This inspection took place on 23 January 2017 and was led by a CQC Inspector who was supported by a specialist dental advisor. Before the inspection, we asked the practice to send us some information for review and this included a summary of complaints received.

During the inspection we spoke with four dentists (including a principal dentist), three dental nurses, and the practice manager. We reviewed policies, procedures and other documents. We also obtained the views of 14 patients who used the service. This was either through CQC comment cards that we had provided for patients to complete during the two weeks leading up to the inspection or speaking with them in person during the inspection.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 27 March 2017

We carried out an announced comprehensive inspection on 23 January 2017 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

The Dental Surgery known locally as March Dental Surgery is located in the market town of March. The practice is located in a two storey building with patient services provided on the ground and first floor. The practice has two waiting rooms and six treatment rooms, four of which are on the ground floor.

One of the principal dentist’s is registered with the Care Quality Commission (CQC) as an individual. Like registered providers, they are ‘registered persons’. 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.

The practice employs five dentists, two dental hygienists, six dental nurses and three further trainee nurses. The staff team is supported by a practice manager.

As part of the inspection, we received feedback through 12 CQC comments cards completed by patients, speaking with other patients and staff during the inspection. Patients said that the staff were caring and helpful to them and they received good care and treatment.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• There were systems to promote the safe operation of the service which included the reporting of incidents, significant events, accidents and the management of patient safety alerts. However records of actions taken following accidents were not in place.
• The provider had most emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice. However they did not have a sufficient amount of adrenaline and had not considered whether they had enough oxygen for use in a medical emergency.
• Patients told us they were able to get an appointment when they needed one and that staff were considerate, listened to their needs and put them at ease.
• Dentists provided dental care in accordance with current guidelines from the Faculty for General Dental Practice guidelines and the National Institute for Care Excellence (NICE).
• The service was an established dental training practice and also ensured that staff had good access to training and were supported to develop their knowledge and maintain their professional development.
• Governance arrangements were in place for the smooth running of the practice. This included a structured plan to audit quality and safety beyond the mandatory audits for infection control and radiography.

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

• Review the accident procedure so that records of any resulting actions are maintained.
• Review the storage and security of oxygen and consider whether there is a sufficient supply at the location. Review the frequency of equipment checks giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the arrangements for logging and tracking prescription pads held at the practice.
• Review the process for monitoring progress with staff training
• Review patient access to health information leaflets and how to raise a complaint.