Background to this inspection
Updated
18 February 2016
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.
The inspection was carried out on 24 November 2015 by a CQC inspector and a dentist specialist advisor who is a dentist and a specialist advisor who is a dental nurse.
Before the inspection we reviewed information that we held about the provider and information that we asked them to send us in advance of the inspection. This included their statement of purpose and a record of complaints and how they dealt with them.
During the inspection we spoke with three dentists, three dental nurses, the recovery nurse, the practice administrator and the practice manager. We looked around the premises and all of the treatment rooms. We reviewed a range of policies and procedures and other documents including dental care records.
We viewed the comments made by 22 patients on comment cards that we provided before the inspection and a large volume of thank you cards sent in by patients.
We informed the local NHS England area team and Healthwatch (Medway on 28 October 2015) that we were inspecting the practice and 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:
These questions therefore formed the framework for the areas we looked at during the inspection.
Updated
18 February 2016
We carried out an announced comprehensive inspection on 24 November 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
Gibraltar House Dental Clinic is an NHS dental practice which provides general dentistry and also specialises in providing complex treatment for patients such as oral surgery and for nervous patients including those with significant anxieties about having dental treatment. The practice caters for children and adults.
The practice has four dental treatment rooms and two decontamination rooms for cleaning, sterilising and packaging of dental instruments. There is a reception area and waiting room on the ground floor and another waiting area upstairs on the first floor.
The practice has seven dentists and eleven dental nurses. Two dental hygienists provide preventative advice and gum treatments on prescription from the dentists working in the practice. The practice also uses specialist input from three anaesthetists (one adult and two paediatric).
The practice manager and clinical team are supported by an administrator and four receptionists.
The provider is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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.
Before the inspection we sent Care Quality Commission comment cards to the practice for patients to use to tell us about their experience of the practice. We collected 22 completed cards. These provided a positive view of the service the practice provides. We also spoke with five patients. Patients were complimentary about the friendliness and professionalism of staff, the care and treatment they received and the standards of cleanliness at the practice. One comment stated that the service was very good but sometimes it was difficult to get an appointment.
Our key findings were:
- Staff reported incidents and kept records of these which the practice used for shared learning.
- The practice was visibly clean and well maintained.
- Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.
- The practice had effective safeguarding processes and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
- The practice specialised in supporting nervous patients to overcome their anxieties about having dental treatment. Patients were particularly appreciative of the care and understanding they were shown.
- Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).
- The practice provided the option of sedation to patients and carried this out in line with guidelines from the Society for the Advancement of Anaesthesia in Dentistry (SAAD)
- The practice had a written sedation and discharge protocol which was followed by staff.
- The practice took into account any comments, concerns or complaints and used these to help them improve the practice.