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Inspection summaries and ratings from previous provider


Overall summary & rating

Updated 11 February 2016

We carried out an announced comprehensive inspection on 11 January 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 principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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. In addition to the principal, the practice engaged two associate dentists, a hygienist, and employed three trained dental nurses, with one nurse having lead responsibility for managing reception. The practice manager is also a trained dental nurse. All the dental nurses work as a team and are responsible for the cleaning of the practice.

The practice is located at ground level within a range of shops and is accessible to wheelchair users. Due to building constraints the toilets are not accessible for patients with limited mobility but disabled toilet facilities are located nearby.

The practice had two treatment rooms, a staff kitchen area, reception and waiting room and one decontamination room for cleaning, sterilising, and packing dental instruments. The practice is open Monday to Thursday 9.00 am to 5.00 pm, Fridays 9.00 am to 1.00 pm. For private patients, the practice has extended opening hours available.

We spoke with four patients during our inspection and received 41 comments cards that had been completed by patients prior to our inspection. We received positive comments about the cleanliness of the premises, the empathy and responsiveness of staff, and the quality of treatment provided.

Four patients told us that staff explained treatment plans to them well. Patients reported that the practice had seen them on the same day for emergency treatment. Patients commented that the service they received was good, and that they were always clear about the costs involved in their treatment.

Our key findings were:

  • Staff had received safeguarding training and knew the processes to follow to raise any concerns.
  • Staff had been trained to deal with medical emergencies and appropriate medicines and life-saving equipment were readily available and accessible.
  • Infection control procedures were in place and staff had access to personal protective equipment.
  • Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.
  • Patients received clear explanations about their proposed treatment, costs, benefits, and risks and were involved in making decisions about them.
  • Patients were treated with dignity and respect and confidentiality was maintained.
  • The appointment system met the needs of patients and waiting times were kept to a minimum.
  • The practice staff felt involved and worked as a team.
  • We found that systems, and risk assessments, were in place to give oversight and ensure compliance with regulations, and safety however we found that the management of some medicines was not adequately robust to keep patients safe.
  • We found that regular audits of X-rays were not in place to manage performance, identify risks, mitigate, and drive improvements.

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

  • Ensure safe storage and robust stock management of medicines that could be dispensed to patients.
  • Ensure audits relating to X-rays are undertaken at regular intervals to help improve the quality of service.
  • Record peer review discussions for future and reflective learning.
Inspection areas

Safe

No action required

Updated 11 February 2016

We found that this practice was providing safe care in accordance with

the relevant regulations.

The practice had systems and processes in place to ensure all care and treatment was carried out safely.

Staff had received training in safeguarding vulnerable adults and children, and they could describe the signs of abuse and were aware of the external reporting process. Staff were suitably trained and skilled to meet patient’s needs and there were sufficient numbers of staff available at all times.

Infection control procedures were in place and staff had received training. Radiation equipment was suitably sited and used by trained staff only. Emergency medicines in use at the practice were stored safely and checked to ensure they did not go beyond their expiry dates. Sufficient quantities of equipment were in use at the practice, serviced, and maintained at regular intervals.

Effective

No action required

Updated 11 February 2016

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

Consultations were carried out in line with guidance from the National Institute for Health and Care Excellence (NICE). Patients received a comprehensive assessment of their dental needs including taking a medical history. Explanations were given to patients in a way they understood and risks, benefits and options available to them. Patients were referred to other services in a timely manner.

Staff were supported through training, and opportunities for development. Staff had received training in the Mental Capacity Act 2005.

Caring

No action required

Updated 11 February 2016

We found that this practice was providing caring services in accordance with

the relevant regulations.

Patients were treated with dignity and respect and their privacy maintained. Patient information and data was handled confidentially. We saw that treatment was clearly explained and patients were provided with treatment plans.

Patients with urgent dental needs or pain were responded to in a timely manner, usually on the same day.

Responsive

No action required

Updated 11 February 2016

We found that this practice was providing responsive care in accordance with

the relevant regulations.

Appointments were easy to book and the practice offered extended opening hours to meet the needs of those who could not attend during normal opening hours. The practice offered slots each day enabling responsive and efficient treatment of patients with urgent dental needs.

There was a clear complaints procedure and information about how to make a complaint was displayed in the waiting area.

Well-led

No action required

Updated 11 February 2016

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

Staff had received inductions, and regular performance reviews. The practice team were an integral part of the management and development of the practice.

The practice had a number of policies and procedures to govern activity and held regular staff meetings. It proactively sought feedback from staff and patients, which it acted on. However, we found that they did not undertake regular audits of X-rays. These must be undertaken at regular intervals to help improve the quality of service.

We found that that some medicines that could be dispensed to patients were not stored appropriately and there was not a system to ensure that stock was rotated and expiry dates were checked.