9 June 2016
Sheffield Teaching Hospitals NHS Foundation Trust provided acute and community services for approximately 564,000 people in the Sheffield area. The Charles Clifford Dental Hospital (CCDH) is one of five of the main acute sites that belong to the Sheffield Teaching Hospitals NHS Foundation Trust.
CCDH is an NHS hospital built in 1953, providing specialist oral, dental and maxillofacial services, as well as routine dental care for training purposes at no cost for patients in Sheffield city centre and the surrounding areas. Consultations and treatments for routine dental care are undertaken by University of Sheffield (School of Clinical Dentistry) students under the supervision of experienced dentists, consultants, hygienists and therapists. In order to qualify for routine dental treatment at CCDH, patients must not already be undergoing a course of treatment with their local dentist. Emergency care is only provided for patients with acute oral dental problems.
Sedation was undertaken at CCDH; general anaesthesia was not provided at CCDH.
The CCDH is a dental teaching hospital linked to the University School of Clinical Dentistry in Sheffield and has an intake of 80 undergraduate dentists and 30 hygienists and therapists each year. It was currently expanding its post-graduate and research activities. There is a mixture of clinical and academic staff working at CCDH.
In October 2014 the community dental service merged with the CCDH and became a distinct clinical service area. The service was renamed the Charles Clifford Dental Services and has a single management and governance structure.
9 June 2016
We inspected the Charles Clifford Dental Hospital as part of the inspection of Sheffield Teaching Hospitals NHS Foundation Trust from 7 to 11 December 2015. We carried out this inspection as part of the Care Quality Commission (CQC) comprehensive inspection programme.
We rated Charles Clifford Dental Hospital as good. We rated safe, effective, caring and well-led as good. Responsive was rated as outstanding.
Our key findings were as follows:
- Infection control procedures were in place. The environment was clean and where maintenance issues had been identified these had been placed on the risk register.
- The acute dental service was effective and focused on patients and their oral health care.
- Patients and relatives told us they had positive experiences of care within this service.
- The use of clinical audit to monitor effectiveness and initiate improvements in practice was evident.
- The acute dental services at Charles Clifford Dental Hospital (CCDH) were well led.
We saw several areas of outstanding practice including:
- We saw examples of innovative care approaches for extremely anxious patients, and extended working hours to allow patients to attend evening clinics.
However, there were also areas of practice where the trust should make improvements. the trust should:
Ensure that staff are sufficiently trained in mandatory training
Take action in relation to compatibility of radiological imagery and the new electronic record system, to avoid the need for patients to walk between clinical areas mid-procedure which negatively effects their privacy and dignity whilst being treated.
Review governance minutes so they are clearly labelled to identify which dental clinical stream the papers apply to, and have a robust system for taking appropriate action on areas of concern raised within these meetings.
Review pathway documents so they are regularly reviewed, dated, version controlled and monitored.
Review and establish robust procedures for gaining consent of patients for local anaesthetic extractions.
Professor Sir Mike Richards
Chief Inspector of Hospitals
9 June 2016
Safety, effectiveness, caring and well-led were all rated as good. We rated responsive as outstanding.
Staff protected patients from abuse and avoidable harm. Systems for identifying, investigating and learning from patient safety incidents were in place. Infection control procedures were in place. The environment was clean and where maintenance issues had been identified these had been placed on the risk register.
The acute dental service was effective and focused on patients and their oral health care. We saw examples of innovative care approaches for extremely anxious patients, and extended working hours to allow patients to attend evening clinics.
Patients and relatives told us they had positive experiences of care within this service. We saw good examples of staff providing compassionate and effective care.We found staff to be hard working, caring and committed to the care and treatment they provided. Staff and students spoke with passion about their work and conveyed their dedication to what they did.
The use of clinical audit to monitor effectiveness and initiate improvements in practice was evident.
The acute dental services at Charles Clifford Dental Hospital (CCDH) were well led.Organisational, governance and risk management structures were in place.The senior management team were visible and the working culture appeared to be open, transparent and supportive. Both staff and students told us they felt well supported and able to raise any concerns.
We were onsite at the Charles Clifford Dental Hospital for two days.We spoke with 48 members of staff, 15 patients, eight relatives of patients and reviewed 13 sets of patient notes.