Townes & Townes Dental Practice

We carried out this announced inspection on 17 September 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 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 providing well-led care in accordance with the relevant regulations.

Background

Townes and Townes Dental Practice is in Stonehouse, Gloucestershire and provides private dental treatment to adults and children and NHS treatment to children only.

There is level access for people who use wheelchairs and those with pushchairs. Car parking is in a nearby local car park which has spaces for blue badge holders.

The dental team includes two dentists, one dental nurse and one trainee dental nurse, one dental hygienist, and one receptionist. The practice has three treatment rooms.

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 Townes and Townes Dental Practice is the principal dentist.

On the day of inspection, we collected 47 CQC comment cards filled in by patients, reviewed 105 on line feedback forms and spoke with one other patient.

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

The practice is open:

• Monday and Tuesday 08.30am – 6.00pm
• Wednesday and Thursday 08.30am – 5.30pm
• Friday 08.30am – 2.00pm
• Closes at weekends

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 provider had systems to help them manage risk to patients and staff, though these could be better documented.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. Improvements could be made to ensure all staff were up to date with safeguarding training.
• The provider had thorough staff recruitment procedures.
• 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.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• 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.

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

• Take action to ensure audits of radiography, dental care records and antibiotic prescribing are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated. Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Improve the practice systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular with regard to the fire risk assessment and the legionella risk assessment being undertaken by qualified personnel.
• Take action to ensure all the staff have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.
• Take action to ensure all clinicians are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued.
• Implement a system to ensure patient referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner and not lost.