Archived: Stephenson House

Brookside Dental Clinic also provides out of hours emergency dental care from the same premises. We did not inspect the out of hours service.

Patients were referred to the BPDS when their treatment needs could not be met by general dental services. For example; patients with learning disabilities, complex medical problems or severe mental health problems and children with severe behavioural management problems. We saw records were kept to ensure the service could track a patient's progress from referral through to treatment or referral for general anaesthetic and discharge. Appropriate care planning took place and was co-ordinated to provide a seamless service for patients.

There were robust systems in place to ensure that proper, valid, informed consent was obtained before dental treatment was undertaken. Staff knew how and when to contact an Independent Mental Capacity Advocate (IMCA). An IMCA's role is to help particularly vulnerable people who lack the ability to make important decisions about medical treatment.

The service carried out intra-venous sedation and inhalation sedation for patients who were very nervous of dental treatment. Inhalation sedation is a form of sedation, a mixture of nitrous oxide and oxygen breathed through a nosepiece. Intra-venous sedation is a technique whereby a sedating drug is given to a patient by injection. We found that Intra-venous sedation was delivered according to the standards set out by Royal College of Anaesthetists and the Department of Health Standing Committee Guidelines in Conscious Sedation of 2007.

The service sought feedback from their patients in the form of a satisfaction survey. The results for Brookside Dental Clinic had formed part of the overall analysis of patient satisfaction for Buckinghamshire Priority Dental Service (BPDS), There was evidence of a number of audits of the BPDS. These were in addition to those audits identified as mandatory by the Central and North West London NHS Foundation Trust, which were fed into the Trust's clinical governance framework. This meant that the service monitored the quality of their patient care both as an individual clinic and as part of the wider organisation.

We spoke with 15 people and received 36 completed comment cards from people who use services. People said they were respected and received good care by supportive and professional staff. People commented "The service I have been getting is the best, they respect us in all aspects", "The staff are friendly and very good at their jobs." and "I feel safe and respected, not judged".

We looked at care records and saw people's health, social and dependency related needs were assessed and they were involved in developing a recovery plan. People commented 'I have found this service an amazing source of support which is helping me more than I could write on this piece of paper." and "I am more than satisfied with the service provided".

CNWL cooperated with other providers involved in the care of people using services and supported people to access other health and social care services according to their needs. Care was provided in a clean and hygienic environment.

Staff received annual and specialist training and were supported to provide care and treatment to people. Systems were in place to monitor the quality and effectiveness of the services.

Detainees that we spoke with said that the MHIRT "give me the help I need". They said that the service was "good" and described it as "pro-active" in providing care and treatment. They confirmed that full details about their mental health and personal history had been taken by staff when they started using the service.

The MHIRT had access to other healthcare providers within the prison as well as in the community. The general healthcare provision within the prison and the care and treatment of individual detainees were discussed with other professionals, including prison staff, where appropriate.

Staff received appropriate training in mental health as well as working in the prison environment. They had regular supervisions and underwent annual appraisals where their performance was discussed and development plans were put in place.

Detainees using the service had recently been asked to provide feedback on their access to the service and the quality of their treatment. They were able to complain about the service.

Staff completed risk assessments and individual care plans for people with their involvement. People were aware of their care plans and who their care co-ordinator was. People who attended the clozapine clinic told us that they were "satisfied" with the care that they received.

Staff kept people's consultants up to date with their progress, so that they in turn could inform the GPs. A consultant had sought to strengthen ties with GPs by visiting them in their practice.

Staff told us that if they suspected a person was being abused they would report this to their manager. There was a safeguarding policy and procedure which set out the investigation framework to follow if allegations were received about a person being abused.

Staff told us that they received regular supervision which included discussing people on their caseload, their progress and their training needs. They were appraised on their performance annually.

People told us that they knew how to raise concerns and make complaints if they needed to.