The Care Quality Commission
  • Dentist
  • Dentist

Nigel Newtons Dental Care

14 Dowland, Dartmouth Close, Weston Super Mare, Avon, BS22 6LJ (01934) 521789

Provided and run by:
Dr Nigel Newton

All Inspections

28/04/2016

During a routine inspection

Further to the outcome of a previous inspection, carried out in October 2014, we carried out an announced focused inspection relating to the safe provision of conscious sedation on 28 April 2016 to ask the practice the following key questions;

Are services safe, effective, and well-led in relation to conscious sedation?

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 well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations

Background

Nigel Newton’s Dental Care is a mixed dental practice providing NHS and private treatment for both adults and children. The practice is situated in a converted residential property based in a suburb of Weston-Super-Mare.

The practice has one dental treatment room and a separate decontamination room for cleaning, sterilising and packing dental instruments. Also included is a reception and waiting area.

The practice has a dentist who is also the practice owner, a lead dental nurse who acts as the practice manager and two part-time trainee dental nurses.

The practice owner is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Our key findings were:

All of the requirements set out by the Care Quality Commission in relation to conscious sedation at the previous practice inspection had been met:

  • Whilst not currently providing conscious sedation the governance systems in place to underpin the provision of this treatment gave us confidence it would be provided safety.
  • An empowered practice manager oversaw the maintenance of clinical governance systems.
  • Staff involved in the provision of conscious sedation had been trained to handle medical emergencies.
  • Appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
  • Staff received appropriate joint update training by the Society for the Advancement of Anaesthesia in Dentistry (SAAD) in relation to the provision of conscious sedation in a ‘high street’ dental care setting.
  • The necessary monitoring equipment to ensure the safe provision of conscious sedation was available.
  • Standard operating procedures were in place for the use of medicines involved in conscious sedation including the maintenance of a stock of the reversal agent for the sedative medicine.
  • Two appropriately trained staff supported patients during their conscious sedation.

30 September 2014

During a routine inspection

We undertook an inspection in order to assess if the provider had met the compliance actions made following our visit in February 2014.

We found the provider had been responsive to the compliance actions and had taken appropriate action to ensure the service was fully complaint and safe for patients.

For example, we saw the provider had refurbished the waiting room, patient toilet and areas of the surgery. We observed measures had been put in place which meant patients could access additional information about the practice. We saw the provider had installed a self- booking in system which alerted the staff working in the surgery to the arrival of patients.

The provider had processes in place to monitor the quality of service and to enable patients to provide feedback about their treatment We read one comment ' We have been with the practice for about 14 years, we find it very good ' we can ask questions without feeling stupid'.

13 February 2014

During a routine inspection

During our inspection we spoke with five people who visited the practice. They told us they were satisfied with the service provided. One person said 'he's reliable and you don't have to wait long and you always see Dr Newton'.

People told us they could express their views and were given appropriate support and information to make informed treatment choices. One person said 'he's fine no problem, he explains things to you'. While people's views and experiences were taken into account in the way the service was provided and delivered their privacy and dignity was not always respected.

We spoke with the dentist and the dental nurse who had a good understanding of their role in protecting vulnerable adults and children from abuse.

We saw staff did not always follow infection control guidance to ensure people who used the service were protected from the risk of acquiring an infection.

There were not appropriate procedures in place to ensure staff were able to assist people quickly in a medical emergency, if one arose.

People's records were not always kept up to date and accurate to reflect the treatment they had received.

The dentist offered an option of conscious sedation during specific dental procedures for people who were anxious about the dental treatments recommended. Conscious sedation was defined by the Dental Standards Reference Group as: "A technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation. The level of sedation must be such that the patient remains conscious, retains protective reflexes, and is able to respond to verbal commands".

We found appropriate procedures were not in place to ensure people were kept safe during conscious sedation. We saw the practice did not have the appropriate medicine to reverse the effects of sedation if required in an emergency. The dentist told us they had not updated their skills and knowledge of conscious sedation in line with the recommended guidance from The Society for the Advancement of Anaesthesia in Dentistry (SAAD) to ensure the safety and protection of people.