Bracken Dental Practice

We carried out this announced inspection on 11 January 2018 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.

We told the NHS England Cheshire and Merseyside 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 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

Bracken Dental Practice is in a suburb of Liverpool and provides dental care and treatment to adults and children on an NHS and privately funded basis.

There is level access to facilitate entrance to the practice for people who use wheelchairs and for pushchairs. The practice has two treatment rooms. Car parking is available near the practice.

The dental team includes three dentists, four dental nurses and two receptionists. The team is supported by a practice manager.

The practice is owned by an individual. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

We received feedback from 48 people during the inspection about the services provided. The feedback provided was positive about the practice.

During the inspection we spoke to two dentists, dental nurses, receptionists and the practice manager. We looked at practice policies, procedures and other records about how the service is managed.

The practice is open:

Monday and Tuesday 9.00am to 6.00pm

Wednesday 9.00am to 5.30pm

Thursday 9.00am to 5.00pm

Friday 9.00am to 3.30pm.

Our key findings were:

• The practice was clean and well maintained.
• Staff knew how to deal with emergencies. Appropriate medical emergency medicines and equipment were available.
• The practice had infection control procedures in place which reflected published guidance.
• Staff knew their responsibilities for safeguarding adults and children and the practice had processes in place to guide them.
• 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.
• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
• The practice had a procedure in place for dealing with complaints. Details of alternative organisations patients could complain to were not available.
• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had systems in place to help them manage risk. We found that not all reasonably practicable measures to reduce risk had been put in place in relation to sharps and Legionella.
• The practice had staff recruitment procedures in place. References were not obtained for staff prior to employment.

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

• Review the protocol for maintaining accurate, complete and detailed records relating to the employment of staff. This includes ensuring references, are obtained and suitably recorded.

• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from undertaking of the regulated activities, specifically in relation to Legionella, the responsibility for dismantling all used sharps, and the damaged operator’s chair.
• Review the practice’s complaint handling procedures to ensure information about organisations patients can contact, for example NHS England, are available should they not wish to complain to the practice directly or should they not be satisfied with the way the practice dealt with their concerns.