You are here

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Updated 9 November 2018

We undertook a focused inspection of Thorne Road Dental Practice on 18 October 2018. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector.

We undertook a comprehensive inspection of Thorne Road Dental Practice on 18 June 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care in accordance with the relevant regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Thorne Road Dental Practice on our website www.cqc.org.uk.

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

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

The provider had made improvements in relation to the regulatory breach we found at our inspection on 18 June 2018.

Background

Thorne Road Dental Practice is in Doncaster and provides NHS and occasional private treatments to adults and children. Thorne Road Dental practice is part of the P B Robinson Group.

There is step access into the practice without adequate space for a ramp to assist people who use wheelchairs. Patients who require step free access are referred to a practice nearby. Car parking is available near the practice and some parking is available on the main road for patients with blue badges.

The dental team includes three dentists, three dental nurses and one receptionist. The practice has four treatment rooms with only three in use.

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 Thorne Road Dental Practice was the area manager.

During the inspection we spoke with the area manager and received e-mail correspondence from the company director to support our findings. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 8am – 5pm

Our key findings were:

  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had improved the practice systems to help them manage risk to patients and staff. This included the process to manage safety checks for facilities and electrical equipment.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were now available.
  • The provider had reviewed its infection control procedures which now reflected published guidance.
  • The provider had put systems in place to monitor and track prescriptions and referrals to other service providers.
  • The provider had reviewed its systems of providing preventive care and supporting patients to ensure better oral health.
  • The provider had put systems in place to monitor and track prescriptions and referrals.
  • The provider had reviewed the responsibilities for the practice cleaner.
  • The provider had reviewed its responsibilities in respect to the needs of patients with disabilities.

There were areas where the provider could make improvements. They should:

  • Review the practice’s processes to ensure that facilities checks are completed in a timely manner, in particular: portable appliance testing.
  • Review the practice’s processes in line with the fire risk assessment to ensure the actions required are completed, in particular: In-house smoke detector function checks.
Inspection areas

Safe

No action required

Updated 20 July 2018

We found that this practice was providing safe care in accordance with the relevant regulations. We identified concerns which the practice took immediate action to risk assess and take the appropriate action. The likelihood of them occurring in the future is low. We will be following up on our concerns to ensure they have been put right by the provider.

The practice had systems and processes to provide safe care and treatment. They used learning from incidents and complaints to help them improve.

With the exception of one staff member, the dental team had received appropriate training in safeguarding and knew how to recognise the signs of abuse. The system to monitor safeguarding training and reporting procedures could be improved.

Staff were qualified for their roles and the practice completed essential recruitment checks.

Improvements could be made to ensure that facilities and equipment were safe. For example, ensure that timely maintenance and servicing schedules are in place.

We found the systems in place to manage the safe use of X-ray equipment could be improved.

Premises and equipment were clean and properly maintained. A review of designated cleaning areas was required to mitigate unnecessary risk to the practice cleaner.

The practice followed national guidance for sterilising and storing dental instruments.

Some areas of the infection prevention and control process did not follow recommended guidance for cleaning dental instruments. For example, instruments were not cleaned under temperature monitored water.

Some systems to manage risk could be improved. For example, the sharps risk assessment did not reflect the process in place and no risk assessment was carried out for manual instrument cleaning.

There was no process in place to monitor and track prescriptions.

The practice had arrangements for dealing with medical and other emergencies. The process was not managed in line with recognised guidance, several items of the medical kit were missing and this had not been identified.

Effective

No action required

Updated 20 July 2018

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

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as very good. The dentists discussed treatment with patients so they could give informed consent but this was not consistently recorded in the patient care records.

We identified improvements could be made to ensure oral health preventive care and support to patients was delivered in line with the Delivering Better Oral Health toolkit and the British Society of Periodontology.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

There was no system in place to monitor and track referrals.

The practice supported staff to complete training relevant to their roles. Improvements could be made to help them monitor this.

Caring

No action required

Updated 20 July 2018

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

We received feedback about the practice from 27 people. Patients were positive about all aspects of the service the practice provided. They told us staff were kind and sensitive.

They said that they were given helpful, honest explanations about dental treatment, and said their dentist listened to them. Patients commented that they made them feel at ease, especially when they were anxious about visiting the dentist.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 20 July 2018

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

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain.

The practice had access to interpreter services, the needs of people who were hearing impaired had not been considered.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 9 November 2018

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

The provider had made improvements to the management of the service. This included establishing clear roles and responsibilities for all the practice team. The improvements provided a sound footing for the ongoing development of effective governance arrangements at the practice

Staff were able to demonstrate they were aware of the safeguarding reporting procedures and the safeguarding policy had been updated to include notification to CQC. All relevant training had been completed.

The process to manage safety checks for facilities and electrical equipment had been improved. Fixed wiring, gas safety checks and portable appliance testing had either been carried out or were in the process of being completed.

Improvements had been made to ensure the safe use of X-ray equipment. Recommended actions from a safety survey carried out in November 2017 had now been completed.

The provider had made improvements to ensure risk management was in place. We saw evidence to support the risks associated with safe use of sharps, manual instrument cleaning and fire safety had been addressed. We identified two areas within fire safety which could be improved further; these areas were discussed with the area manager and accepted.

Improvements had been made to the systems to monitor emergency medicines and equipment in line with recommended guidance. All identified medicines and equipment previously missing from the emergency kit were now accounted for.

Improvements had been made to the systems to monitor infection prevention and control processes and the disposal of dental plaster. An updated infection prevention control audit had been undertaken and any additional areas for improvement were documented on the action plan.

A process was now in place to monitor and track prescriptions and referrals to other service providers.

During our previous visit to the practice we identified areas where improvements could be made to monitor the consistency of detail recorded in patient dental care records, in addition we highlighted concerns relating to clinical awareness and treatment of oral health preventative care. We received a documented statement from the company director detailing the positive action taken to address these concerns.