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Cherry Orchard Dental Practice

Inspection Summary


Overall summary & rating

Updated 12 March 2019

We carried out this announced inspection on 7 February 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

Cherry Orchard Dental Practice is in Newcastle under Lyme 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 in the practice car park or in a pay and display car park near the practice.

The dental team includes two dentists, a visiting implantologist, three dental nurses (who also cover reception duties) and a practice manager. The practice has three treatment rooms.

The practice is owned by a corporate organisation 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 Cherry Orchard Dental Practice is the practice manager.

On the day of inspection, we collected 11 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, two dental nurses, one receptionist, the practice manager, an area development manager and the lead regulatory officer. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 9am to 1pm and from 2pm to 5pm.

Our key findings were:

  • The practice was part of a large corporate group which had a Support Centre based in Manchester where support teams including human resources, IT, finance, health and safety, learning and development, clinical support and patient support services were based. These teams supported and offered expert advice and updates to the practice when required.
  • 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.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had thorough staff recruitment procedures. The practice had access to support from a dedicated human resources and recruitment team based within the company’s head office.
  • 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 were providing preventive care and supporting patients to ensure better oral health.
  • The appointment system took account of patients’ needs. Patients could access routine treatment and urgent and emergency care when required.
  • The provider had effective leadership and culture of continuous improvement.
  • Staff felt involved and supported and worked well as a team. There was an effective staffing structure which extended to senior management who were visible and supported the practice manager on the day of our visit by basing themselves at the practice.
  • The provider asked staff and patients for feedback about the services they provided. This practice was on a pilot scheme to request additional patient feedback and was currently placed first out of fourteen practices in the group for receiving the most positive feedback.
  • The provider dealt with complaints positively and efficiently.
  • The provider had suitable information governance arrangements.
Inspection areas

Safe

No action required

Updated 12 March 2019

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. This included support from a lead regulatory office who completed regular audits to ensure safety and compliance processes were kept up to date.

They used learning from incidents and complaints to help them improve. The practice had management tools to log all complaints and incidents so that they could be tracked and monitored by support staff within their Support Centre. An incident reporting poster with contact details was on display in the staff room.

Staff received training in safeguarding people and knew how to recognise the signs of abuse and how to report concerns. Safeguarding contact details were displayed in the practice manager’s office and the staff room. The contact numbers were regularly checked by the practice manager on the NHSE Safeguarding Contacts App.

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

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had suitable arrangements for dealing with medical and other emergencies. A medical emergency flow chart was on display in the staff room and in additional to annual basic life support training, the team completed medical emergency scenario training every three months.

Effective

No action required

Updated 12 March 2019

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 excellent, professional and very supportive of nervous patients. 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 provider supported staff to complete training relevant to their roles and had systems to help them monitor this. The company funded online training for all employed staff and had a learning management system in place to facilitate core training. External training such as basic life support was provided in house for all staff. The dental nurses had extended duties which included radiography and implantology nursing to enhance patient support.

Staff understood the importance of obtaining informed consent and of working in accordance with relevant legislation when treating patients who might lack capacity to make decisions.

Caring

No action required

Updated 12 March 2019

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

We received feedback about the practice from 11 people. Patients were positive about all aspects of the service the practice provided. They told us staff were extremely supportive, caring and compassionate.

They said that they were given unrushed and detailed explanations about dental treatment and said their dentist listened to them. One patient advised that previously they had not visited a dentist for a ten year period due to being dental phobic. They advised that since seeing a particular dentist at this practice they have attended all of their appointments and the team were very respectful and understanding of their needs.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect. We observed reception staff talking to patients at the reception desk cheerfully and politely.

Responsive

No action required

Updated 12 March 2019

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

The practice’s appointment system took account of patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. This included providing facilities for patients with a disability and families with children. The practice had access to telephone and face to face 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. The practice logged all complaints on an online tracker which was monitored by patient support services within the Support Centre to support further if required.

Well-led

No action required

Updated 12 March 2019

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

The practice was part of a large corporate group which had a Support Centre based in Manchester where support teams including human resources, IT, finance, health and safety, learning and development, clinical support and patient support services were based. These teams supported and offered expert advice and updates to the practice when required.

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. This extended to senior management who were visible and supported the practice manager on the day of our visit by basing themselves at the practice.

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

The provider 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.