2:30 Limited

We carried out this announced inspection on 26 July 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

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 form the framework for the areas we look at during the inspection.

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

2:30 Limited is in Corby, a town in the East Midlands. It provides NHS and private treatment to adults and children. The practice provides general dentistry services.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice in public car parks. There are two designated spaces for blue badge holders directly outside the practice.

The dental team includes nine dentists, 12 dental nurses (two of the nurses work as receptionists), three trainee nurses, one decontamination assistant, one dental hygienist, one dental hygiene therapist and two practice managers.

The practice has nine treatment rooms; four are on ground floor level. There are two separate decontamination rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at 2:30 Limited is one of the principal dentists.

On the day of inspection, we collected 39 CQC comment cards filled in by patients.

During the inspection we spoke with four dentists, four dental nurses (including one who works as a receptionist) and one of the practice managers. We looked at practice policies and procedures, patient feedback and other records about how the service is managed.

The practice is open: Monday, Wednesday and Thursday from 8.30am to 5.30pm, Tuesday from 8.30am to 8pm, Friday from 8.30am to 3.30pm and on Saturday by appointment.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance. We noted some areas for review to ensure the practice was always following best practice guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and most life-saving equipment were available. We noted that not all sizes of clear face masks for self-inflating bags were held. These were ordered after the day of our inspection.
• The provider had most systems to help them manage risk to patients and staff. We noted some areas that required management oversight, such as water temperature testing for legionella. Follow up action was taken by the provider after our inspection.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines. We found exceptions in relation to basic periodontal examination (BPE) and further detail was required in some patient records.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff provided preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the practice’s system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review guidance regarding basic periodontal examination (BPE) from the British Society of Periodontology.
• Review all staff awareness of the requirements relating to consent, the Mental Capacity Act 2005 and Gillick competence and ensure staff know their responsibilities in relation to this.
• Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff.