Updated 7 January 2019
We carried out this announced inspection on 11 December 2016 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
My Dentist – Union Road is in Oswaldtwistle, Lancashire and provides NHS and private treatment to adults and children.
There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including a space for blue badge holders, are available at the rear of the practice.
The dental team includes three dentists. One of these was a dentist from outside the European Union, who is under supervision at the start of their validation period. There were also seven dental nurses, one of whom is a trainee, and one dental hygiene therapist. The clinical team are supported by two receptionists and a practice manager. The practice has six treatment rooms, three on the ground floor and three on the first floor.
The practice is owned by a partnership 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 My Dentist Union Road Oswaldtwistle is the practice manager.
On the day of inspection, we collected 12 CQC comment cards filled in by patients.
During the inspection we spoke with three dentists, two dental nurses, a receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open from Monday to Friday between 8.45am and 5.30pm
Our key findings were:
- The practice appeared clean and well maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to help them manage risk to patients and staff. Where the use of a rubber dam had been refused by a patient, the safety devices used as an alternative, were not specifically recorded in patient notes by dentists.
- 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.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- Staff were providing preventive care and supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs, prioritising those patients that needed to see a dentist quickly.
- 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 efficiently. We noted a rise in complaints about access to dental services. This was being addressed. However, recruitment of new dentists to address problems with patient access would not have an effect until early in 2019.
- The provider had suitable information governance arrangements.
There were areas where the provider could make improvements. They should:
- Review the practice's staffing levels, in particular for dentists, to ensure the practice can provide routine appointments in a timely manner to its patients.
- Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society. Particularly, the recording of other safety systems used in place of a rubber dam.