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Inspection Summary


Overall summary & rating

Updated 14 August 2018

We carried out this announced inspection on 19 June 2018 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

New Park House Dental Centre is in Shrewsbury and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including for blue badge holders, are available near the practice.

The dental team includes eight dentists (one of whom is a specialist endodontist), 13 dental nurses, six dental hygienists, two decontamination assistants, two receptionists, one administrator and a practice manager. A qualified medical practitioner also visits the practice on an ad hoc basis to provide sedation to patients. The practice has eight treatment rooms.

The practice is owned by a partnership 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 New Park House Dental Centre was one of the senior partners.

On the day of inspection, we collected 21 CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, three dental nurses, one dental hygienist, two receptionists and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Wednesday, Thursday: 8.30am to 5.30pm

Tuesday: 8.30am to 7.30pm

Friday: 8am to 5pm

Our key findings were:

  • The practice appeared clean and well maintained.
  • The practice had infection control procedures which reflected published guidance. The registered manager took immediate action when an incident took place that did not reflect current guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. Some items required replacement and this was immediately addressed by staff.
  • The practice had systems to help them manage risk.
  • The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had staff recruitment procedures. Some improvements were required and this was addressed promptly by staff.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The practice was providing preventive care and supporting patients to ensure better oral health.
  • The appointment system met patients’ needs.
  • The practice had effective leadership and had recently undergone new ownership. They were continuously implementing new improvements. The current owners purchased the practice four months before our visit and had already made many positive changes to the practice
  • Staff felt involved and supported and worked well as a team.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice dealt with complaints positively and efficiently.
  • The practice had suitable information governance arrangements.

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

  • Review the practice’s system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
  • Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
  • Review the practice's protocols and procedures to ensure staff are up to date with their mandatory training and their continuing professional development. In particular, the safeguarding of children and vulnerable adults.
  • Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.
Inspection areas

Safe

No action required

Updated 14 August 2018

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

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

Staff knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed recruitment checks. Some information was missing from staff personnel files and an action plan was produced to ensure the necessary documentation was available.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments. The registered manager took immediate action when an incident took place that did not reflect current guidance.

The practice had suitable arrangements for dealing with medical and other emergencies. Some items required replacement and this was immediately addressed by staff.

Effective

No action required

Updated 14 August 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 exceptional and excellent. The dentists discussed treatment with patients so they could give informed consent and recorded this in their records.

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

The practice supported staff to complete most training relevant to their roles. They had recently implemented systems to help them monitor this. Not all staff had completed training in safeguarding children and vulnerable adults. This was immediately addressed and the majority of staff completed training within one day of our visit.

The staff were involved in quality improvement initiatives such as good practice and peer review as part of its approach in providing high quality care.

Caring

No action required

Updated 14 August 2018

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

We received feedback about the practice from 21 people. Patients were positive about all aspects of the service the practice provided. They told us staff were friendly, polite and professional.

They said that they were given helpful explanations about dental treatment, and said their dentist listened to them. Patients commented that staff made them feel at ease, especially when they were anxious about visiting the dentist. They commented that the whole team was lovely and that the practice was child-friendly.

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 14 August 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.

Staff considered patients’ different needs. This included providing facilities for disabled patients and families with children. The practice had access to interpreter services and had arrangements to help patients with sight or hearing loss.

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 14 August 2018

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

The current owners purchased the practice four months before our visit and had made many positive changes to the practice. We found that the senior partners acted quickly and effectively to address a number of shortfalls identified in our inspection. This demonstrated to us that they were committed to improving their service.

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided. There was a clearly defined management structure and staff felt supported and appreciated.

The practice team kept complete patient dental care records which were typed and stored securely.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.