The Dental Surgery Barnsley

We carried out this announced inspection on 13 January 2020 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, (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

The Dental Surgery is in Barnsley and provides NHS dental care and treatment for adults and children.

There is portable ramp access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available at the practice and on nearby local roads.

The dental team includes three dentists, three dental nurses (one of whom is a trainee), one dental hygiene therapists, two receptionists and a practice manager who is also a dental nurse. 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 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 The Dental Surgery Barnsley is the company director (provider).

On the day of inspection, we collected 36 CQC comment cards filled in by patients. All comments received reflected positively on the service provided.

During the inspection we spoke with the provider, two dental nurses, the dental hygiene therapist, receptionists and the practice manager. The company manager was also present at the inspection. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 9am to 5:30pm.

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 available. Improvement was required to ensure emergency medical equipment was checked weekly.
• The provider had systems to help them manage risk to patients and staff. Improvement was required to ensure Legionella management systems and sharps risks were supported by an appropriate risk assessment.
• 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.
• Control measures were required in one treatment room for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017.
• Staff treated patients with dignity and respect and took care to protect their 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 culture of continuous improvement.
• Leadership and oversight of systems could be improved to ensure these were supported by a lead person in the absence of the provider.
• 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 dealt with complaints positively and efficiently.
• The provider had information governance arrangements, adjustments could be made to ensure best practice in respect of use of mobile telephones and the location of computer screens.

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

• Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular: ensure all sharps in use are risk mitigated and the systems are embedded within the team.
• Take action to implement recommendations in the practice's Legionella risk assessment and ensure it includes all areas, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular: Implement control measures for staff to follow in respect to the treatment room which has two entry doors.
• Review current systems to ensure best practice in line with General Data Protection Regulation requirements. In particular: position of computer screens and use of own mobile telephones to conduct work related tasks.
• Review the practice’s arrangements to ensure systems are supported by a lead person where necessary to ensure good governance and leadership are sustained in the longer term.