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Inspection Summary


Overall summary & rating

Updated 11 April 2017

We carried out an announced comprehensive inspection on 6 March 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

Gargrave Road Dental Practice is located near the centre of Skipton in North Yorkshire and provides private treatment to adults and children. They offer restorative dentistry, dental implants, orthodontics and cosmetic treatments.

Wheelchair users or pushchairs can access the practice through a ramp access at the rear of the building. Car parking is available near the practice.

The dental team is comprised of a dentist, four dental nurses (one of whom is a trainee), two dental hygienists, and a cleaner.

The practice accommodates three surgeries, a waiting area and reception, and a staff room/kitchen.

On the day of inspection we received 31 CQC comment cards providing positive feedback. The patients were complimentary about the care they received at the practice. They told us they found the staff caring and compassionate.

The practice is open: Monday, Tuesday, and Friday 9am-5pm and Wednesday 8:30am-4pm.

The principal dentist 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.

Our key findings were:

  • The practice appeared clean and well maintained.
  • Infection control procedures were robust and the practice followed published guidance.
  • Staff had been trained to handle medical emergencies and appropriate medicines and equipment were readily available in accordance with current guidelines.
  • The practice had systems in place to manage risks.
  • Staff understood and received safeguarding training and knew how to recognise signs of abuse and how to report it.
  • There were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Treatment was well planned and provided in line with current guidelines.
  • Patients were treated with dignity and respect and confidentiality was maintained.
  • The appointment system met patients’ needs.
  • The service was aware of the needs of the local population and took these into account in how the practice was run
  • The practice was well-led and staff felt involved and supported and worked well as a team.
  • The practice sought feedback from staff and patients about the services they provided.
  • Complaints were responded to in an efficient and responsive manner.
  • Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
  • Recruitment needed to be brought in line with the recruitment procedure.
  • Staff kept up to date with the professional training but we noted that staff appraisals were not in place.

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

  • Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal references taken and ensuring recruitment checks, including references, are suitably obtained and recorded.

  • Review the learning and development needs of individual staff members and have an effective process established for the on-going assessment and appraisal of all staff.

Inspection areas

Safe

No action required

Updated 11 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 ensure all care and treatment was carried out safely. For example, there were systems in place for infection prevention and control, clinical waste control, dental radiography and management of medical emergencies.

All emergency equipment and medicines were in date and in accordance with the British National Formulary (BNF) and Resuscitation Council UK guidelines.

Staff told us they felt confident about reporting incidents, accidents and Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).

Staff had received training in safeguarding patients and knew how to recognise the signs of abuse and who to report them to including external agencies such as the local authority safeguarding team.

Staff were suitably qualified for their roles but we found recruitment needed to be brought in line with the recruitment procedure and staff appraisals in place.

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Infection prevention and control procedures followed recommended guidance from the Department of Health: Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices.

Effective

No action required

Updated 11 April 2017

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

Patients’ dental care records contained comprehensive information about their current dental needs and past treatment. The practice monitored any changes to the patient’s oral health and made in house referrals for specialist treatment or investigations where indicated.

The practice followed best practice guidelines when delivering dental care.

Staff were encouraged and supported to complete training relevant to their roles and this was monitored by the principal dentist. The clinical staff were up to date with their continuing professional development (CPD).

Informed consent was obtained and recorded.

Caring

No action required

Updated 11 April 2017

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

Patients were very positive about the staff, practice and treatment received. We left CQC comment cards for patients to complete two weeks prior to the inspection. There were 31 cards returned. Comments from nervous or anxious patients confirmed they felt well supported by the staff at the practice.

The staff recognised and respected people’s diversity, values and human rights.

Dental care records were stored securely.

We observed patients being treated with respect and dignity during interactions at the reception desk, over the telephone and as they were escorted through the practice. We also observed staff to be welcoming and caring towards the patients.

Privacy and confidentiality were maintained for patients using the service on the day of the inspection.

Responsive

No action required

Updated 11 April 2017

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

The practice had dedicated slots each day for emergency dental care and every effort was made to see all emergency patients on the day they contacted the practice.

Patients commented they could access treatment for urgent and emergency care when required. There were clear instructions for patients requiring urgent care when the practice was closed.

There was a procedure in place for responding to patients’ complaints. This involved acknowledging, investigating and responding to individual complaints or concerns. Staff were familiar with the complaints procedure.

Well-led

No action required

Updated 11 April 2017

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

There was a clearly defined management structure in place and all staff felt supported and appreciated in their own particular roles. The principal dentist was responsible for the day to day running of the practice.

Regular clinical and non-clinical audits were completed as part of a system of continuous improvement and learning.

Patient satisfaction surveys were completed and actions taken from findings.

Staff were encouraged to share ideas and feedback as part of their appraisals and personal development plans. All staff were supported and encouraged to improve their skills through learning and development.

The practice held regular staff meetings which were minuted and gave everybody an opportunity to openly share information and discuss any concerns or issues.