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Inspection Summary


Overall summary & rating

Updated 15 February 2017

We carried out an announced comprehensive inspection on 15 December 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

The dental practice is located in a converted Victorian building and provides predominantly NHS treatment to patients of all ages. There are six treatment rooms, a consulting room, a decontamination room for sterilising dental instruments, a staff room/kitchen and two general offices. Access for wheelchair users or pushchairs is possible from the ground floor entrance, which lead into the spacious reception and waiting area. Street car parking is available close to the practice.

The practice is open Monday to Thursday 08.45 -17.15, Friday 08.45 -16. 00. The practice did not open at weekends.

The dental team is comprised of five dentists, a practice manager, eleven dental nurses of whom two are trainees, three dental hygienists, one dental therapist, and three receptionists.

The practice provides general dentistry. One of the dentists is involved in the local mountain rescue team and two dentists work for the NHS emergency dental team.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We reviewed ten CQC comment cards on the day of our visit; patients were extremely positive about the staff and standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment. Two staff had completed the comments cards and both commented that it was a very good practice to work for and that they felt supported.

Our key findings were:

  • The practice was well organised, visibly clean and free from clutter.
  • An Infection prevention and control policy was in place. We saw the sterilisation procedures followed recommended guidance.
  • The practice had systems for recording incidents and accidents.
  • Practice meetings were used for shared learning.
  • The practice had a safeguarding policy and staff were aware on how to escalate safeguarding issues for children and adults should the need arise.
  • Staff received annual medical emergency training. Equipment for dealing with medical emergencies reflected guidance from the Resuscitation Council (UK).
  • Dental professionals provided treatment in accordance with current professional guidelines.
  • Patient feedback was regularly sought and reflected upon.
  • Patients could access urgent care when required.
  • Dental professionals were maintaining their continued professional development (CPD) in accordance with their professional registration.
  • Complaints were dealt with in an efficient and positive manner.
  • The practice was actively involved in promoting oral health.

There were areas where the provider could make improvements and should:

  • Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal reference taken and ensuring recruitment checks, including references, are suitably obtained and recorded.

  • Review the practice’s system for the recording and the checking of fire safety procedures.
Inspection areas

Safe

No action required

Updated 15 February 2017

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

Infection prevention and control procedures followed recommended guidance from the Department of Health: Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices.

Equipment for decontamination procedures, radiography and general dental procedures were tested and checked according to manufacturer’s instructions.

Medicines were stored appropriately, both for medical emergencies and for regular use and were in accordance with the British National Formulary (BNF) and Resuscitation Council UK guidelines.

Staff we spoke with were knowledgeable about safeguarding systems for adults and children.

The practice had processes for recording and reporting any accidents and incidents.

Risk assessments (a system of identifying what could cause harm to people and deciding whether to take any reasonable steps to prevent that harm) were in place for the practice.

Effective

No action required

Updated 15 February 2017

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

Dental professionals referred to resources such as the National Institute for Health and Care Excellence (NICE) guidelines and the Delivering Better Oral Health toolkit (DBOH) to ensure their treatment followed current recommendations.

Staff obtained consent, dealt with patients of varying age groups and made referrals to other services in an appropriate and recognised manner.

Staff who were registered with the General Dental Council (GDC) met the requirements of their professional registration by carrying out regular training and continuing professional development (CPD).

Caring

No action required

Updated 15 February 2017

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

Patients were very positive about the staff, practice and treatment received. We left CQC comment cards for patients to complete two weeks prior to the inspection. There were eight responses all of which were very positive, with patients stating they felt listened to and received the best treatment at that practice.

Dental care records were kept securely on computer systems which were password protected and backed up at regular intervals.

We observed patients being treated with respect and dignity during our inspection and privacy and confidentiality were maintained for patients using the service. We also observed staff to be welcoming and caring towards patients.

The waiting room was equipped with dental information leaflets and magazines.

Responsive

No action required

Updated 15 February 2017

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

The practice had dedicated slots each day for urgent dental care and every effort was made to see all emergency patients on the day they contacted the practice.

Patients had access to telephone interpreter services when required and the practice provided a range of aids for different disabilities including hand rails and a toilet which could accommodate wheelchairs and pushchairs.

Well-led

No action required

Updated 15 February 2017

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

We found there were strong support systems in place to ensure the smooth running of the practice.

There were dedicated leads in infection prevention and control and safeguarding as well as various policies for staff to refer to.

The practice manager kept all staff files, training logs and certificates and ensured there were regular quality checks of clinical and administration work. There was a ‘flag’ system on the computer which highlighted when policies required review or equipment services were due.

Staff were encouraged to provide feedback on a regular basis through staff meetings and informal discussions.

Patient feedback was also encouraged verbally and online. The results of any feedback were discussed in meetings for staff learning and improvement.