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Inspection Summary


Overall summary & rating

Updated 30 July 2015

We carried out a comprehensive inspection of TDSML on 21 May 2015. TDSML is located in the City of London and provides private dental services primarily to adults.

The practice team included eight dentists, six dental hygienists, 14 dental nurses, five receptionists and one practice manager.

We reviewed 37 Care Quality Commission (CQC) comment cards completed by patients who were very positive about the care they received from the practice. They commented that staff were caring, respectful and helpful.

One of the principal dentists 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 had systems in place to help ensure patient safety. This included effective instrument decontamination practices.
  • Staff had received training appropriate to their roles.
  • Staff were knowledgeable about patient confidentiality and we observed good interaction between staff and patients during the inspection.
  • Patients were able to make routine and emergency appointments when needed
  • The patient comment cards we reviewed indicated that patients were consistently treated with kindness and respect by staff. It was reported that communication with patients, access to the service and to the dentists, was good. Patients reported good access to the practice.

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

  • Adopt an individual risk based approach to patient recalls having regard to National Institute for Health and Care Excellence (NICE) guidelines.
  • Ensure a practice adult safeguarding policy is developed in order to signpost staff who may have concerns.
  • Ensure a business continuity plan is in place to deal with foreseeable emergencies that could impact on the running of the practice.
  • Ensure clinical and non-clinical audits e.g. X-ray and infection control are carried out periodically.
  • Ensure patient records are kept with due regard to General Dental Council guidelines.
  • Conduct quarterly testing of the ultra-sonic bath in accordance with Department of Health guidance.
  • A system is established for the stock control of medicines such as antibiotics and fridge temperature is checked on a daily basis.
  • Conduct water temperature checks as recommended in Legionella risk assessment.

We found that this practice was providing safe, effective, caring, responsive and well-led care in accordance with the relevant regulations.

Inspection areas

Safe

No action required

Updated 30 July 2015

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

The practice had a system to assess and manage risks to patients. They had safe systems in place including for decontamination of dental instruments, health and safety, staff recruitment and training and the management of medical emergencies.

Staff told us they felt confident about reporting incidents and accidents. We reviewed incidents that had taken place in the past year and found the practice had responded appropriately.

Effective

No action required

Updated 30 July 2015

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

Patients told us through comment cards that they were given time to consider and make informed decisions about which treatment option they wanted. The dental care records we looked at included details of the condition of the patient’s teeth and soft tissues lining the mouth and gums. The practice manager ensured there were sufficient staff to meet patient needs.

Staff received professional development appropriate to their role and learning needs. Staff who were registered with the General Dental Council (GDC) had frequent continuing professional development (CPD) and were meeting the requirements of their professional development.

Caring

No action required

Updated 30 July 2015

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

We looked at 37 CQC comment cards patients had completed prior to the inspection. Patients were positive about the care they received from the practice. They commented they were treated with respect and dignity. We observed privacy and confidentiality were maintained for patients using the service on the day of the inspection.

Responsive

No action required

Updated 30 July 2015

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

We found the practice had an efficient appointment system in place to respond to patients’ needs. There were vacant appointments slots for urgent or emergency appointments each day.

We observed the waiting area was large enough to accommodate patients with wheelchairs and prams. The layout allowed for easy access to the reception area, toilet and treatment rooms.

Well-led

No action required

Updated 30 July 2015

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

The practice had systems in place to seek and act upon feedback from patients using the service, including carrying out a patient survey. The practice manager ensured there were systems to monitor the quality of the service that were used to make improvements to the service. However some audits had not been reviewed in the past year. The staff described the practice culture as supportive, open and transparent. Staff demonstrated an awareness of the practice’s purpose and were proud of their work and team.