Bewdley Dental Practice

Updated 3 May 2016

We carried out an announced comprehensive inspection on 19 January 2016 as part of our planned inspection of all dental practices. The inspection took place over one day and was carried out by a lead inspector and a dental specialist adviser.

We informed NHS England area team that we were inspecting the practice, they did not have any concerns to report.

During our inspection visit, we reviewed policy documents and staff records. We spoke with seven members of staff, including the management team. We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. We were shown the decontamination procedures for dental instruments and computer system that supported the patient treatment records and patient dental health education programme. We reviewed comment cards completed by patients and spoke with three patients. Patients gave very positive feedback about their experience at the practice.

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 therefore formed the framework for the areas we looked at during the inspection

Updated 3 May 2016

Bewdley Dental Practice is owned by two dentist partners and also has three associate dentists who work part time, eight qualified dental nurses who are registered with the General Dental Council (GDC), four dental hygienists, a practice manager and a part time receptionist. The practice’s opening hours are from 8.15am to 5.30pm Monday to Thursday and from 8.15am to1pm on Friday. The practice is closed between the hours of 1pm to 2pm Monday to Thursday.

Bewdley Dental Practice provides NHS and private treatment for adults and children. The practice is situated in a converted property. The practice has five dental treatment rooms; two on the first floor and three on the second floor and a separate decontamination room for cleaning, sterilising and packing dental instruments. There is also a reception and two waiting areas, one on each floor.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We collected 36 completed cards and spoke with three patients.

Our key findings were:

• The practice had mechanisms in place to record significant events and accidents.

• The practice had systems to help ensure patient safety. These included safeguarding children and adults from abuse, responding to medical emergencies and maintaining equipment.

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

• There were sufficient numbers of suitably qualified staff to meet the needs of patients.

• Patients were treated with dignity and respect and their confidentiality was maintained.

• The practice was visibly clean and well maintained.

• Options for treatment were identified and explored and patients said they were involved in making decisions about their treatment.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• Health promotion advice was given to patients appropriate to their individual needs such as smoking cessation or dietary advice.

• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation

• Staff received training appropriate to their roles and told us they felt well supported to carry out their work.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

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

•  Review procedures to ensure learning points from incidents and complaints are shared with all relevant staff and any improvements demonstrated.
• Register with the MHRA to receive medicine safety alerts and ensure that any alerts relevant to the practice are discussed with staff and actions taken as appropriate.
• Review the storage arrangements for temperature sensitive medicines ensuring they are stored in line with manufacturers ‘instructions.
• Review that the practice’s infection control practices to ensure that when staff are manually cleaning dental instruments they visually inspect all items under an illuminated magnifier to ensure they are clean in line with the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
• Review documentation use for fire safety checks at the practice and ensure that staff who complete these checks sign to confirm that they have done so.
• Undertake reviews and audits of consent and provide consent records that contain full details of conversations held.
• Implement a stock control system with documentation to enable staff to be aware of medicines available at the practice at all times.
• Establish and operate an effective staff appraisal system which enables to staff to raise issues or concerns and to receive feedback about their work at the practice. Personal development plans should be included within the appraisal process.
• Implement a system to ensure that dental care record audits are undertaken to help improve the quality of service.