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Inspection Summary


Overall summary & rating

Updated 24 March 2017

We carried out an announced comprehensive inspection on 8 February 2017 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

Hextable Dental Centre is located in Hextable in kent. The practice is located within a pharmacy and provides private dental services.

The practice is open Monday 9am to 6pm, Tuesday 9am to 1pm, Wednesday from 9am to 6pm. Thursday Closed. Friday 9am to 1pm and Saturday 9am to 1pm. The practice facilities include one consultation/treatment room, reception and waiting area, and a decontamination room.

We received feedback from 16 patients. Patient feedback was very positive about the service. Patients told us that staff were professional and caring and treated them with respect. They described the service as very good and providing an excellent standard of care. Information was given to patients appropriately and that staff were helpful.

The provider 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.

Our key findings were:

  • The practice investigated significant and safety events and cascaded learning to staff.
  • There were systems to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
  • There were systems to ensure that all equipment, including the suction compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment were working appropriately.
  • Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
  • Patients’ care and treatment was planned and delivered in line with current legislation and evidence based guidelines such as that from the National Institute for Health and Care Excellence (NICE).
  • The practice ensured staff were trained and that they maintained the necessary skills and competence to support the needs of patients.
  • There were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
  • Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
  • 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 had a procedure for handling and responding to complaints, which were displayed and available to patients.
  • The practice was well-led and staff felt valued, involved and worked as a team. Staff meetings were routinely held to help share information and learning.
  • Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical and non-clinical audits were carried out to monitor the quality of services.
  • The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.
Inspection areas

Safe

No action required

Updated 24 March 2017

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

The practice had systems for identifying, investigating and learning from incidents relating to the safety of patients. The infection prevention and control practices at the surgery followed current essential quality requirements. All equipment at the practice was regularly maintained, tested and monitored for safety and effectiveness.

Patients were protected against the risks of abuse or harm through the practice policies and procedures. Staff were trained to recognise and report concerns about patients’ safety and welfare and had access to contact details for the local safeguarding team.

There were arrangements to deal with medical emergencies and staff had annual training

Patients’ medical histories were obtained before any treatment took place. The dentists were aware of any health or medication issues which could affect the planning of treatment.

There were procedures for recruiting new staff and these were followed consistently. All of the appropriate checks including employment references, proof of identification and security checks were carried out when new staff were employed. The staff were suitably trained and skilled to meet patient’s needs and there were sufficient numbers of staff available at all times.

Effective

No action required

Updated 24 March 2017

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

Consultations were carried out in line with current guidelines such as those from the National Institute for Health and Care Excellence (NICE). Patients received a comprehensive assessment of their dental needs including a review of their medical history. Dental care records were detailed and included details of risks of conditions such as oral cancer and advice about alcohol and tobacco consumption.

The practice ensured that patients were given sufficient information about their proposed treatment to enable them to give informed consent.

The staff kept their training up-to-date and received professional development appropriate to their role and learning needs. Staff who were registered with the General Dental Council (GDC) demonstrated that they were supported by the practice in continuing their professional development (CPD) and were meeting the requirements of their professional registration.

Health education for patients was provided by the dentists. Also information leaflets were available within the practice waiting area. They provided patients with advice to improve and maintain good oral health. We received feedback from patients who told us that they found their treatment successful and effective.

Caring

No action required

Updated 24 March 2017

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

Patients were complimentary about the practice and how the staff treated them. Patients commented positively on how caring and helpful staff were, describing them as friendly, compassionate and professional.

Patients felt listened to and were given appropriate information and support regarding their care or treatment. They felt their dentist explained the treatment they needed in a way they could understand. They told us they understood the risks and benefits of each treatment option. Staff had a good awareness of how to support patients who may lack capacity to make decisions about their dental care and treatment.

Responsive

No action required

Updated 24 March 2017

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

Appointment times met the needs of patients and waiting time was kept to a minimum. Staff told us all patients who requested an urgent appointment would be seen on the same day or within 24 hours. They would see any patient in dental pain, extending their working day if necessary.

Patients who had difficulty understanding care and treatment options were suitably supported.

The practice had a procedure for dealing with complaints. One of the dentists told us there had been two complaints made in the last 12 months.

Well-led

No action required

Updated 24 March 2017

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

Staff felt supported and empowered to make suggestions for the improvement of the practice. There was a culture of openness and transparency. Staff at the practice were supported to complete training for the benefit of patient care and for their continuous professional development.

There was a pro-active approach to identify safety issues and make improvements in procedures. There was candour, openness, honesty and transparency amongst all staff we spoke with.

Patients’ views were regularly sought by way of a patient survey and comments which were acted upon as required.