You are here

The provider of this service changed - see old profile

All reports

Inspection report

Date of Inspection: 16 September 2013
Date of Publication: 2 October 2013
Inspection Report published 02 October 2013 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 16 September 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with staff, reviewed information given to us by the provider and took advice from our pharmacist. We took advice from our specialist advisors.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

We spent nine hours observing the services provided by the practice and found that; care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. The dentists we spoke with told us they checked people’s medical history and asked about any changes to their health before an examination commenced. The majority of the patients we spoke with told us, “They always ask for changes to medical conditions and medications. I’m asked about changes each time I come here.” We checked records of twelve people who had been seen in the practice that day. The records showed people were consulted about changes in medical history and medication before they received treatment.

In the patient records we looked at we saw records which demonstrated discussions had taken place about dental treatments or oral health. We saw treatment plans were based on a full mouth assessment and the length of appointments varied according to the treatments required. We saw from records and heard from patients, how the dentists discussed and advised patients about the treatments that most benefitted them. For example, the risks involved in having a crown fitted to a tooth and the possible loss of nerve sensitivity.

Intravenous sedation was not carried out by the practices dentists but was carried out by a oral surgeon from the local hospital. The surgeon had a dedicated surgery and provided services to people from a number of local dental practices following referrals from individual dentists. We saw how the surgeon was supported by a qualified dental nurse who had sedation training and that oxygen and appropriate medication was immediately available for use if an emergency should occur in line with current guidelines. The surgeon and nurse explained the process they were to carry out and we heard how regular patient checks were carried out. We spoke with a patient who received this service, they spoke positively about the treatment and about the pre and post-operative information and care they received. For people not requiring this type of treatment we heard how the provider spent time reassuring patients to build their confidence so that sedation was unnecessary. This showed people received safe and appropriate treatment.

There were arrangements in place to deal with foreseeable emergencies. Records showed and the dentist and nurses we spoke with confirmed they had completed recent emergency first aid training. The practice had suitable emergency resuscitation equipment for both children and adults. Each surgery had an emergency call system facility which allowed the dental nurses to request additional support if required. Oxygen and medicines for the use of in an emergency were also available at the practice. Records demonstrated regular checks were completed to ensure the emergency equipment and emergency medication held was always available and fit for use.

We saw how emergency treatment appointments for people with urgent dental needs were made available each day. We heard staff receiving calls from people telephoning the practice to arrange appointments and how reception staff offered a choice of appointment. People arriving for emergency treatment told us they were able to get appointments promptly and at a time that suited them. This showed people could access treatment when they needed it. The reception staff told us an answer phone message detailed how to access emergency out-of-hours treatment.

People’s care and treatment was planned and delivered in a way that protected them from unlawful discrimination. The practice was situated close to a main bus route but parking was limited in the area; the entrance to the practice involved using steps and was not easily wheelchair accessible. Information on the NHS Choices website made it clear that access to the practice was restricted. However the provider had fitted handrails to the steps to enable people to use the steps more easily. Ground floor surge