Archived: Appleby and Associates Dental Practice

Updated 16 December 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 registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008

We carried out an announced, comprehensive inspection on 23 November 2016. The inspection was led by a CQC inspector who was supported by a specialist dental adviser and a second CQC inspector.

We reviewed information we held about the practice prior to our inspection.

During the inspection we spoke with the principal dentist, the associate dentist, the hygienist and dental nurses.

To assess the quality of care provided we looked at practice policies and protocols and other records relating to the management of the service.

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 16 December 2016

We carried out an announced comprehensive inspection on 23 November 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

Appleby and Associates Dental Practice is a dental practice providing private care for adults and private and NHS care for children. Some treatment is provided under a fee per item basis and some under a dental insurance plan. The practice is situated in a converted single storey property; therefore all patient facilities are on the ground floor.

The practice has two dental treatment rooms and a separate decontamination room where cleaning, sterilising and packing of dental instruments takes place. There is also a reception and waiting area and other rooms used by the practice for office facilities and storage. The practice is open from 8.00am to 7.30pm on Mondays, from 8.00am to 5.00pm Tuesday to Thursdays and from 8.00am to 4.30pm on Fridays. The practice shuts for lunch between 12.30pm and 1.30pm each day.

The practice has two dentists and is able to provide general dental services including endodontic (root canal) treatment. They both work four days per week. They are supported by a part time hygienist and six part time dental nurses who also carry out reception duties.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience. We also spoke with patients on the day of our inspection. We received feedback from 35 patients. These provided an overwhelmingly positive view of the services the practice provides. Patients commented on the high standard of care, the friendliness and professionalism of staff, the cleanliness of the practice and the efficiency of all staff.

Our key findings were:

• Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect; and they were involved in discussions about treatment options.

• Patients said they had no problem getting appointments whether routine or more urgent.

• The practice was visibly clean and well maintained and infection control standards were in line with national guidance.

• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD). However they had not received appraisals of their performance.

• The practice had suitable facilities and was well equipped to treat patients and meet their needs. However the practice did not have access to a translation service for patients who did not speak English, or a hearing loop to support patients with a hearing impairment.

• The practice had medicines and equipment for use in a medical emergency which were in accordance with national guidelines. However the frequency these were checked was not in line with national guidance. Some equipment was out of date on the day of our inspection but replaced immediately.

• There was a system to identify, investigate and learn from significant events. However there were inconsistencies in how incidents were reported and recorded.

• Some governance arrangements were in place for the smooth running of the service. However we found that risks in respect of fire had not been assessed and policies relating to key areas were not available.

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

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events to ensure events are recorded and investigated appropriately.

• Review the availability of a hearing loop for patients with hearing difficulties and translation services for patients whose first language is not English.

• Review stocks of medicines and equipment and the system for identifying and disposing of out-of-date stock.

• Review governance arrangements, including acting on recommendations of the fire risk assessment, making appropriate policies available and implementing staff performance appraisals.

• Review the security of prescription pads in the practice to ensure there are systems to monitor and track their use with reference to the NHS guidance on security of prescription forms August 2013.