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Inspection summaries and ratings from previous provider


Overall summary & rating

Updated 7 January 2016

We carried out an announced comprehensive inspection on 13 October 2015 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

Brookfield Dental Care is located in Rushden, Northamptonshire and treats both NHS and private dental patients, with the majority being private patients (approximately 90%). The practice has three dentists. two dental therapists, a hygienist, a practice manager and five additional dental care professionals (DCP).

The practice is situated in a converted house with a car park at the rear of the practice and provides services from the ground floor only and is wheelchair accessible.

The practice opening hours are Monday and Friday 8.30am to 5pm with late opening on Tuesday, Wednesday and Thursday until 6pm.

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 of the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We viewed 45 comment cards that had been completed by patients about the services provided. All cards reported positive comments with the exception of one regarding charges. Patients’ comments reported experiencing an excellent service, and highlighted the friendliness and professionalism of the staff and that the dentists made patients feel relaxed and comfortable. We also spoke with four patients during the inspection who all told us that they had received an excellent service and felt well cared for by all staff.

Our key findings were:

  • The practice had a system for recording significant events and complaints and staff knew how to follow the process if there was an event or a complaint received.
  • All staff had received safeguarding vulnerable adults and children, and whistle blowing training and knew what to do and how to raise any concerns.
  • The practice was clean and well maintained.
  • There were sufficient numbers of suitably qualified and experienced staff to meet the needs of patients.
  • Staff had been trained to deal with emergencies, although they had not carried out regular scenario practice as recommended by Resuscitation Council.
  • There were appropriate medicines and life-saving equipment available.
  • The practice had infection control procedures which were in line with national guidance.
  • Patients’ care and treatment was planned and delivered in line with evidence based guidelines, good practice and current legislation with the exception of rubber dams which were not routinely used.
  • Patients received explanations about their proposed treatment, costs, options and risks and were involved in making decisions.
  • Patients were treated with dignity and respect and their confidentiality was maintained.
  • The practice was well-led and staff worked as a team.
  • Governance systems were effective and the practice completed a range of clinical and non-clinical audits to monitor the quality of services. However, we did not always see evidence of action taken as a result, for example, testing water temperatures at sentinel points.
  • The practice sought feedback from staff and patients about the services they provided.

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

  • Review their practice in relation to endodontic procedures with particular reference to the use of rubber dam in line with British & European Endodontic Society guidelines.
  • Require all clinicians to carry out radiograph audit on an annual basis with results, action sheets if appropriate and completion sheets populated.
  • Introduce checking procedures and recording for testing water temperatures at sentinel points and ensure this is performed regularly in line with the recommendations of their own agency report
  • Carry out regular performance appraisals with the practice manager.
  • Review standards, guidelines and regulations to ensure all staff are aware.
  • Rationalise the filing system for radiation protection.
Inspection areas

Safe

No action required

Updated 7 January 2016

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

The practice had policies and procedures to ensure all care and treatment was carried out safely. Significant events, complaints and accidents were recorded, investigated and analysed.

Patients were informed if and when mistakes had been made. Staff had received training in safeguarding vulnerable adults and children and whistle blowing and knew the signs of abuse and who to report any concerns to. The recruitment procedures kept patients safe, although the practice had not carried out a risk assessment on a new member of staff whilst awaiting return of their Disclosure and Barring Check (DBS). Staff were trained and skilled to meet patients’ needs. There were sufficient numbers of staff available at all times. Induction procedures were in place and completed by all new members of staff.

The practice had infection control procedures in place and staff had received relevant training. There was a maintenance schedule in place for radiation equipment, but the equipment service was three months overdue and had been arranged for a date three weeks after our inspection. However, when we raised this issue with the practice they took immediate action and provided evidence that the servicing had taken place within the next two days. Emergency medicines were available and checked appropriately but they were stored in an area which could be accessed by the public. The practice took immediate measures to relocate the equipment.

Effective

No action required

Updated 7 January 2016

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

During the inspection we looked at records and saw evidence of detailed oral examinations, treatment planning, options discussed, treatment declined with possible risks, smoking and alcohol habits, and the gaining of valid and informed consent.

We observed an awareness and use of the Delivering Better Oral Health (DBOH) toolkit for preventative measures. Medical history taking protocols were robust. We saw evidence that appropriate referrals were made by letter for suspected pathology, orthodontics and complex treatments and internally to one associate for surgical treatments.

Rubber dam was not universally deployed by all clinicians for root canal treatment although this is recommended by British and European Endodontic Society guidelines.

Staff had knowledge and awareness of Mental Capacity Act MCA and Gillick competency.

Caring

No action required

Updated 7 January 2016

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

All patients views we sought were positive. Patients had provided feedback and comments either through a comments book in reception, comment cards or in person.

Staff at the practice treated patients with dignity and respect and maintained their privacy, although the location of reception was in close proximity to the waiting area which made it possible for conversations to be overheard. Staff ensured that patients had understood their treatment plan and options when they had left the dentist by discussing this after their consultation and offered an opportunity to ask any questions.

Patients confirmed that they were able to ask questions and staff explained the treatment options and the costs of any treatment before it began.

Responsive

No action required

Updated 7 January 2016

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

Information regarding oral health was readily available to patients. The practice was accessible to patients with restricted mobility, with level access.

Patients were able to access treatment quickly in the event of an emergency usually the same day and the practice had its own arrangement of out of hours treatment with the practice manager and a dentist on call at all times.

The principal dentist wrote to patients with more complex treatment plans to ensure that the patients were clear in the treatment required and the costs involved.

Well-led

No action required

Updated 7 January 2016

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

The practice had arrangements in place for monitoring and improving the services provided to patients. Regular checks and audits were completed to ensure the practice was safe and patients’ needs were being met.

The practice had a range of up-to-date policies and procedures to ensure the practice was safe and met patients’ needs. Responses to patients concerns and complaints had been recorded, and demonstrated an open supportive approach.

Staff meetings were held monthly and staff were able to submit suggestions for the agenda. The majority of the staff had worked at the practice long-term and reported feeling valued and well supported.