Family Dental Practice

Updated 4 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection was carried out on 7 June 2016 by a CQC inspector and a dental specialist adviser. Before the inspection we reviewed information we held about the provider and information that we asked them to send us in advance of the inspection.

During the inspection we spoke with five members of the practice team including dentists, dental nurses and a receptionist. We looked around the premises including the treatment rooms. We viewed a range of policies and procedures and other documents and read the comments made by 27 patients in comment cards provided by CQC before the inspection. We also saw the results of the practice’s own surveys and the NHS Friends and Family test results for the last 12 months.

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 4 July 2016

We carried out an announced comprehensive inspection on 7 June 2016 to ask the practice the following key questions: Are services safe, effective, caring, responsive and well-led?

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

Family Dental Practice is situated in Shipston-on-Stour and mainly provides NHS dental treatment. Private treatment is available if patients request this. The practice has two dentists, two dental nurses and one trainee dental nurse. The clinical team are supported by two reception staff.

The two dentists are in partnership as the owners and registered providers. One of the partners 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.

The practice has two dental treatment rooms. The practice is in the process of setting up a separate decontamination room for the cleaning, sterilising and packing of dental instruments. In the meantime staff carry out these processes in the treatment rooms. There is level access from the front entrance into the reception, waiting room and one treatment room. Some patients with disabilities choose to use the rear entrance which has a step down but is closer to the adjacent car park. The patient toilet is has a grab rail for patients with physical disabilities but is not large enough for wheelchairs. There are two steps up to the other treatment room. The office and the staff areas are on the first floor of the building and are reached by an external staircase.

The practice is open from 9am to 5pm Monday to Friday. Reception is staffed during the lunch hour so that patients can speak to someone if they call in or telephone during that time.

Before the inspection we sent Care Quality Commission comment cards to the practice so patients could tell us about their experience of the practice. We collected 27 completed cards and looked at the practice’s own monthly patient survey results and the NHS Friends and Family test results for the last 12 months. These provided a consistently positive view of the practice and the care and treatment patients received. Patients described the whole practice team as caring, friendly, reassuring and efficient. Several patients commented on how well the dentists explained the treatment they needed and the effort they took to make sure they understood. The NHS Friends and Family test results showed that from a total of 408 responses, 316 patients said they were extremely likely to recommend the service and 80 were likely to recommend it.

Our key findings were:

• The practice was visibly clean and feedback confirmed this was patients’ experience. The practice had systems to assess and manage infection prevention and control and were making improvements to the decontamination arrangements at the practice.

• The practice had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.

• The practice had clear processes for dealing with medical emergencies and for ensuring that dental equipment was regularly maintained.

• Dental care records provided clear and detailed information about patients’ care and treatment.
• Staff received training appropriate to their roles and were supported in their continued professional development. The practice supported new staff and used a structured induction process.

• Patients were able to make routine and emergency appointments when needed.

• The practice used in-house surveys and the NHS Friends and Family test to obtain patients’ views.

• Patients were positive about the service provided by the practice. They said this met their needs and that staff were reassuring, respectful and professional.

• The practice had established governance processes to help them manage the service. The partners were investing in the practice and were in the process of improving the physical environment and facilities.

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

• Review the storage of temperature sensitive dental care products and medicines to ensure they are stored in line with the manufacturer’s guidance and the refrigerator temperature is monitored and recorded.
• Review the ease with which staff can access Glucagon, a medicine for patients needing urgent first aid for seriously lowered blood sugar.
• Review the practice’s protocols for the use of a rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society
• Review the practice’s X-ray audits to ensure all of the expected aspects of radiography are included.