Swallownest Dental Practice Partnership

We carried out this announced inspection on 10 June 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 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 not providing well-led care in accordance with the relevant regulations.

Background

Anderson Broadberry and Smith is in Sheffield 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 are available at the practice.

The dental team includes five dentists, eight dental nurses, one dental hygiene therapist, one receptionist and a practice manager. The practice has five treatment rooms. An area of the building not used by the dental practice was utilised by a dental technician who works there on a self-employed basis.

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 the time of inspection at Anderson Broadberry and Smith was the one of the dentists.

On the day of inspection, we collected 29 CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, two dental nurses, the dental hygiene therapist, the receptionist 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 to Friday 8am – 6pm.

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.
• The practice had systems to help them manage risk to patients and staff; areas such as sharps and sepsis management required review.
• Safeguarding processes were in place. Most of the staff knew their responsibilities for safeguarding vulnerable adults and children. Improvements could be made to embed practice procedures fully within the team.
• The provider had thorough staff recruitment procedures.
• In most respects clinical staff provided patients’ care and treatment in line with current guidelines. We noted in some areas where guidance was not always followed.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff were providing preventive care and supporting patients to ensure better oral health, in some area’s guidance was not always being followed.
• The appointment system took account of patients’ needs.
• Clinical oversight and leadership could be improved.
• The practice had systems for continuous improvement: audit processes for the completion of radiography and patient care records were not effective.
• Staff felt involved and supported and worked well as a team.
• General awareness of the Mental Capacity Act 2005 and Gillick competence was limited.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements. Improvement was needed to ensure information recorded in patient care records was consistent.

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review the practice's protocols for patient assessments and ensure they are in compliance with current legislation and take into account relevant nationally recognised evidence-based guidance. In particular: British Society of Periodontology (BSP) and the Faculty of General Dental Practice (UK) (FGDP).