Woodstock Dental Practice

We undertook a follow-up desk based focused inspection of Woodstock Dental Practice on 22 July 2020.

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 carried out by a CQC inspector who had remote access to a specialist dental adviser.

We undertook a comprehensive inspection of 2 December 2019 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 and was in breach of Regulations 15 and 17 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 Woodstock 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 areas where improvement was required.

This desk-based inspection was undertaken during the Covid 19 pandemic.

Due to the demands and constraints in place because of Covid 19 we reviewed the action plan and asked the provider to confirm compliance after a reasonable interval, focusing on the areas 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 breaches we found at our inspection on 2 December 2019.

Background

Woodstock Dental Practice is in Woodstock and provides NHS and private dental care and treatment for adults and children.

The practice reception is accessed by a step down into the waiting area. Staff assist patients into the practice when required. Public car parking spaces, including dedicated parking spaces for disabled people, are available outside the practice.

A wheelchair accessible, public toilet is available across the road from the practice. Staff told us they provided the funds for patients to use this facility when needed.

The dental team includes two dentists, four dental nurses of which two also undertake reception duties, three dental hygienists and one receptionist.

The practice has three treatment rooms.

The practice is owned by an organisation and as a condition of registration must have a person registered with the CQC 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 Woodstock Dental Practice is the principal dentist.

The practice is open:

• Monday, Tuesday and Thursday 8.30am to 5.00pm
• Wednesday 8.30am to 7.00pm
• Friday 9.00am to 1.00pm

Our key findings were:

• Premises used by the service were properly maintained.
• Systems and processes were put in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk.

We carried out this announced inspection on 2 December 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 Care Quality Commission 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Woodstock Dental Practice is in Woodstock and provides NHS and private dental care and treatment for adults and children.

The practice reception is accessed by a step down into the waiting area. Staff assist patients into the practice when required. Public car parking spaces, including dedicated parking spaces for disabled people, are available outside the practice.

A wheelchair accessible public toilet is available across the road from the practice. Staff told us they provided the funds for patients to use this facility when needed.

The dental team includes two dentists, four dental nurses, of which two also undertake reception duties, three dental hygienists and one receptionist.

The practice has three treatment rooms.

The practice is owned by an organisation and as a condition of registration must have a person registered with the CQC 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 Woodstock Dental Practice is the principal dentist.

On the day of inspection, we collected 71 CQC comment cards filled in by patients and spoke with three other patients.

During the inspection we spoke with one dentist, two dental nurses, one dental hygienist and a receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday, Tuesday and Thursday 8.30am to 5.00pm
• Wednesday 8.30am to 7.00pm
• Friday 9.00am to 1.00pm

Our key findings were:

• The practice appeared to be visibly 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 generally available.
• The provider had systems to help them manage risk to patients and staff but improvements were needed.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures which reflected current legislation.
• 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.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had systems in place to deal with complaints positively and efficiently.
• The provider had information governance arrangements.

We identified a regulation 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. Specifically,, management of fire safety, infection control, legionella safety, electrical safety, emergency medicines and equipment.

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Implement a system to ensure patients referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner and not lost.
• Take action to ensure audits of radiography, infection prevention and control and patient dental care records ensuring that, where appropriate, have documented learning points and the resulting improvements can be demonstrated.