10 Dental

Updated 12 October 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.

This inspection took place on the 19 September 2016. The inspection team consisted of a Care Quality Commission (CQC) inspector and a dental specialist advisor.

Prior to the inspection we reviewed information we held about the provider. We also reviewed information we asked the provider to send us in advance of the inspection. This included their latest statement of purpose describing their values and their objectives, a record of any complaints received in the last 12 months and details of their staff members, their qualifications and proof of registration with their professional bodies.

During the inspection we toured the premises and spoke with two of the dentists, three qualified dental nurses, the assistant practice manager and the lead receptionist. To assess the quality of care provided we looked at practice policies and protocols and other records relating to the management of the service.

We informed the NHS England area team that we were inspecting the practice; we did not receive any information of concern from them.

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 12 October 2016

We carried out an announced comprehensive inspection on 19 September 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

10 dental is situated close to Southport town centre. The practice has four dental treatment rooms, three hygienists’ rooms and a dedicated treatment room used for implant surgery and conscious sedation. Waiting rooms, reception areas and patient toilets are located on both floors of the premises. A comfortable non clinical room is available to discuss treatment options with patients if required and to hold staff meetings. The practice has dedicated X-ray and decontamination rooms in addition to storage and office facilities. There is easy access for patients with restricted mobility and families with pushchairs or young children; with treatment available in one of the ground floor treatment rooms.

The Practice offers mainly private treatment (approximately 95%) to patients of all ages and some NHS dental care services to children. The services provided include preventative advice and treatment, routine and restorative dental care, orthodontics and placing dental implants. One of the dentists carries out conscious sedation. (Conscious sedation - these are techniques 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 practice has one principal dentist, who is the owner, and three associate dentists. There are three hygienists, four qualified dental nurses, a trainee dental nurse in addition to an assistant practice manager, who is also a registered dental nurse, and receptionist. The practice is open on Monday, Tuesday, Thursday and Friday from 8.30am until 5.00pm; each Wednesday from 8.30am until 6.00pm and alternate Saturday mornings from 8.30 am until 12.30 pm.

The principal dentist 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.

29 patients provided feedback to us about the service and we reviewed patient feedback gathered by the practice over the last 12 months. Feedback from patients was overwhelmingly positive about the care they received from the practice. They commented that staff put them at ease, listened to their concerns and they had confidence in the dental services provided. Patients told us they had no difficulties in arranging routine and emergency appointments.

Our key findings were:

• We found the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding, recruitment and the management of medical emergencies.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• Patients told us they were treated with kindness and respect by staff. The practice provided conscious sedation to patients and staff were knowledgeable about how to support patients who were nervous.
• Patients commented they felt listened to ,were fully involved in their treatment and that they had confidence in the dental care provided.
• Staff were knowledgeable about how to support patients who were nervous.
• There were clearly defined leadership roles within the practice and staff told us that they felt supported and comfortable to raise concerns or make suggestions.
• Patients were able to make routine or emergency appointments when needed. There were clear instructions for patients regarding out of hours care.
• The dental practice had effective clinical governance and risk management structures in place. There were systems to monitor and continually improve the quality of the service; including a programme of clinical and non-clinical audits.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients. Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice owner.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.