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Inspection Summary


Overall summary & rating

Updated 29 March 2018

We carried out this announced inspection on 27 February 2018 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 CQC inspector who was supported by a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information of concern.

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 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

Queensway dental clinic is located in Billingham and provides NHS and private treatment to adults and children. The dental clinic is spread across two buildings; the main building being predominantly for NHS treatments and the opposite “crown” building being for private treatments. Each building has it’s own reception, waiting area, a dedicated sterilisation suite and patient facilities. There are 17 treatment rooms between the two sites.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available, including a multi-storey car park opposite the practice.

The clinic provides general dental treatment and specialist dental treatment including oral and maxillofacial surgery, complex endodontics, conscious sedation, implants, specialist orthodontics (by referral to their sister practice which is on the 1st floor of the “crown” building) and specialist restorative procedures. In addition, there is a dental laboratory within the premises.

The dental team includes five principal dentists, five associate dentists, five specialist oral surgeons, a dentist with specialist interest in endodontics, an oral and maxillofacial surgeon, a restorative dentist, two dental hygienists and five dental therapists. In addition, there are seven reception staff, 25 dental nurses, three sterilisation technicians, a governance and compliance manager, patient support supervisors, a patient treatment advisor, a dedicated stock controller and a business administrative team.

Queensway dental clinic is an accredited teaching practice in extended duties for dental nurses –such as oral health, sedation, implant assistance and radiography. An on-site education centre provides facilities for these courses and also for continuing professional development for all dental professionals.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission 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 managers at Queensway dental clinic are one of the principal dentists and the governance manager.

On the day of inspection we collected 10 CQC comment cards filled in by patients which gave us a positive view of the practice.

During the inspection we spoke with the governance and compliance manager, three dentists, the treatment advisor, five dental nurses, a sterilisation technician, a dental therapist, a dental hygienist and reception staff.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday to Friday8:15am – 5:30pm.

Our key findings were:

  • The practice was clean, well maintained and had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies and appropriate medicines and life-saving equipment were available.
  • The practice had systems to help them manage risk.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had thorough staff recruitment procedures.
  • Clinical staff provided patients’ care and treatment in line with current guidelines for general dentistry, implants and specialist treatments.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system met patients’ needs.
  • The practice had effective leadership. Staff felt supported and worked well as a team.
  • Staff well-being was evidently a large priority to the partners of the practice. Numerous health and well-being options were available to staff.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice dealt with complaints positively and efficiently.
  • The practice was largely involved in oral health promotion and provided dental care abroad. Oral health talks were given to various groups (schools, dementia clinics) throughout the region.

We identified areas of notable practice.

  • Diabetes risk assessment was carried out by the dental hygienist using a set of seven questions. Those deemed at risk of diabetes were then referred to their general practitioner and the risk assessment sent with the referral.
  • Staff well-being was evidently a priority. Various measures for team building and learning were in place, as well as free access to support groups. In addition, physical aids were provided and exercise events such as yoga and walking also took place.
  • Staff participated in oral health discussions with local communities such as schools, autistic groups and dementia groups. There were reciprocal learning measures in place with some of these groups to help both the dental team and the community.

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

  • Review the practice's policy for assessing hazardous products identified under the Control of Substances Hazardous to Health (COSHH) 2002 Regulations and ensure a risk assessment is undertaken for all relevant materials held on-site.
  • Review the practice’s systems for tracking and monitoring antibiotics and prescription pads.

Inspection areas

Safe

No action required

Updated 29 March 2018

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. They used learning from incidents and complaints to help them improve.

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 and the practice completed essential recruitment checks.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had suitable arrangements for dealing with medical and other emergencies. There was a logging system for the prescription of medicines and antibiotics dispensed; this required reviewing in terms of detail.

We found the practice had maintained all safety data sheets for hazardous materials held on-site; they did not undertake risk assessments for each material in accordance with guidance from the Health and Safety Executive.

Effective

No action required

Updated 29 March 2018

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

The dentists and dental professionals assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients commented they were treated with respect and dignity in a clean environment and that staff were sensitive to their specific needs. The dentists and dental professionals discussed treatment with patients so they could give informed consent and recorded this in their records.

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

The practice supported staff to complete training relevant to their roles.

Caring

No action required

Updated 29 March 2018

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

We received feedback about the practice from 10 people. Patients were positive about all aspects of the service the practice provided. They told us staff were caring, friendly and professional. 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 29 March 2018

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. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. This included providing facilities for disabled patients and families with children. The practice had access to interpreter services and had arrangements to help patients with sight or hearing loss.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 29 March 2018

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

There was a clearly defined management structure and staff felt supported and appreciated.

Each member of staff had a specific role or responsibility within the practice. This helped to support the principal dentists and also encouraged staff to be involved in all practice duties. It was evident the skill mix within the practice was conducive to improving the overall outcome for patients.

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided.

The practice team kept complete patient dental care records which were stored securely.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.