Updated 13 August 2019
We carried out this announced inspection on 9 July 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
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 form the framework for the areas we look at during the inspection.
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
Butterfly Dental Practice located in of the town of Oswestry, Shropshire and provides private treatment to adults and children. It was registered with the CQC in March 2018.
The practice is situated on the outskirts of Oswestry within an industrial estate. There is dedicated on-site parking next to the practice with no charges enforced. There are no dedicated spaces for blue badge holders. There is level access for people who use wheelchairs and those with pushchairs.
The dental team includes three dentists, one dental nurse who is the practice manager, one dental support worker and one receptionist. The practice has one treatment room.
The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Butterfly Dental Practice is the practice manager.
On the day of inspection, we collected 31 CQC comment cards filled in by patients.
During the inspection we spoke with the practice manager, one dentist, one dental support worker and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday to Friday from 10am to 7pm.
Our key findings were:
- The practice appeared clean and well maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. Staff had completed additional scenario based training within their staff meetings to deal with emergencies.
- The provider had systems to help them manage risk to patients and staff.
- All staff had access to the practice’s policies and procedures via hard copy within the practice and remotely via Dropbox.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures.
- Clinical staff provided evidence that patients’ care and treatment was mostly in line with current guidelines. We saw evidence that antibiotic prescribing and the use of rubber dam were not always in line with current guidance.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- The appointment system took account of patients’ needs with the practice remaining open during weekdays until 7pm for patients who were unable to be seen during the working day.
- The provider had effective leadership and culture of continuous improvement.
- Staff felt involved and supported and worked well as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints efficiently.
- The provider had suitable information governance arrangements.
There were areas where the provider could make improvements. They should:
- Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
- Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
- Introduce protocols regarding the prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
- Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.
- Review the practice's policies and procedures for obtaining patient consent to care and treatment to ensure they are in compliance with legislation, take into account relevant guidance, and staff follow them.