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Inspection Summary


Overall summary & rating

Updated 7 June 2018

We carried out a focused inspection of Wollaston Dental Practice on 26 March 2018.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We carried out the inspection to follow up concerns we originally identified during a comprehensive inspection at this practice on 4 July 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

At a comprehensive inspection we always ask the following five questions to get to the heart of patients’ experiences of care and treatment:

  • Is it safe?
  • Is it effective?
  • Is it caring?
  • Is it responsive to people’s needs?
  • Is it well-led?

When one or more of the five questions is 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 area where improvement was required.

At the previous comprehensive inspection we found the registered provider was providing safe, effective, caring and responsive care in accordance with relevant regulations. We judged the practice was not providing well-led care in accordance with regulation 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 Wollaston Dental Practice on our website www.cqc.org.uk.

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 to put right the shortfalls and deal with the regulatory breach we found at our inspection on 4 July 2017. The provider must ensure that the newly implemented improvements are embedded and sustained in the long-term in the practice.

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

  • Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.

  • Review the processes and systems in place for seeking and learning from patient feedback with a view to monitoring and improving the quality of the service.
Inspection areas

Safe

No action required

Updated 22 August 2017

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.

Staff received training in safeguarding and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles. Evidence of continuing professional development of staff regarding sedation and radiography was not available. The practice mostly completed essential recruitment checks although some checks were missing in one recruitment file seen.

Some areas of the premises and equipment were clean and properly maintained and there were areas that required improvement including the decommissioning of a medical storage refrigerator, ensuring the practice compressor is serviced as set out by current guidelines and that maintenance certificates for the X-ray equipment are always available for inspection.

The practice mainly followed national guidance for cleaning, sterilising and storing dental instruments, but there were areas that required improvement including: de-cluttering of the decontamination area/storage room and kitchenette area and drawers of the treatment room, carrying out further validation tests for the ultrasonic cleaning bath and changing clinical waste bags more frequently to prevent overfilling.

The practice had suitable arrangements for dealing with medical and other emergencies but we did find several minor items missing.

Effective

No action required

Updated 22 August 2017

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

The dentist assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as efficient and effective. The dentist discussed treatment with patients so they could give informed consent and recorded this in their records. Patients told us that they were given both verbal and written information regarding the planned treatment.

There were areas that could be improved with respect to the governance procedures underpinning the provision of intra-venous conscious sedation including: the use of a supplemental oxygen supply cylinder, ensuring that written consent is obtained prior to the sedation appointment rather than on the day of the sedation procedure, ensuring that update training for staff is in line with current recommendations including that for intermediate life support training.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

Caring

No action required

Updated 22 August 2017

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

We received feedback about the practice from two people. Patients were positive about all aspects of the service the practice provided. They told us staff were sociable, kind and caring. They said that they were given detailed explanations about dental treatment, and said their dentist listened to them. Patients commented that they made them feel at ease, especially when they were anxious about visiting the dentist.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 22 August 2017

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

The practice’s appointment system was efficient and met patients’ needs.

Staff considered patients’ different needs. This included providing facilities for disabled patients and families with children. Staff said that they would be able to obtain contact details for interpreter services from the internet if required. There were no arrangements to help patients with sight or hearing loss.

Well-led

No action required

Updated 7 June 2018

The provider had made improvements to the management of the service. This included improvements in systems to monitor the quality of the service provided including audits. Although further improvements were required to ensure that the findings of audits and any learning points noted were discussed with staff. New equipment such as a fridge and compressor have been purchased. Records of continuous professional development of staff were available as were pre-employment information in line with Schedule 3 of the health and social care Act 2008. Staff had completed the required amount of mandatory training and staff were now completing regular fire drills.

A log was now being used to record the expiry dates of medicines and equipment in use at the practice. These were checked on a regular basis and items nearing their expiry were replaced as required.

The provider had failed to address some minor issues we had raised in our previous report; the provider must ensure action is taken to address all outstanding issues.