The Oaks Dental Practice

We carried out this announced inspection on 4 September 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.

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

Ravat and Ray Dental Care (Chorley) Ltd is located in Chorley, Lancashire and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. A car park is available outside the surgery, with allocated spaces for blue badge holders.

The dental team includes four dentists, eight dental nurses, one of whom is a trainee and one dental hygiene therapist. A practice manager is supported by two reception staff and a patient service advisor.

The practice has four treatment rooms, an x-ray development suite and a decontamination facility.

The practice is owned by an organisation and as a condition of registration must have a person registered with the Care Quality Commission (CQC) as the registered manager. Registered managers 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 registered manager of the practice has recently left. CQC are in receipt of an application from the new practice manager, who will be the Registered Manager.

On the day of inspection, we collected 21 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, one dental nurse, one receptionist, the general manager providing cover for the practice manager, and the group operations manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday and Thursday from 8am to 7pm; on Tuesday, Wednesday and Friday from 8am to 6pm. NHS patients that require treatment outside of these hours are referred to the out of hours service provided by the Lancashire Area Team. Patients who have a private dental plan in place, have access to dental services at other practices locally, within that private scheme.

Our key findings were:

• The practice was clean, well maintained and accessible for patients with limited mobility and those patients with prams and pushchairs.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk to patients and staff.
• The practice staff had suitable safeguarding processes and staff understood their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures.
• The clinical 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 provider was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement. The leaders of the organisation worked with the local Deanery, and facilitated placements of foundation year dental students.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

We identified areas of notable practice:-

• The practice worked with outreach workers in the local area, visiting homeless people and offering free oral hygiene kits. Where necessary, people were referred to emergency dental services. Staff also visited local primary schools to provide interactive lessons on effective tooth brushing. In these, children could use large scale models of teeth to understand how perfecting a brushing technique would protect their oral health.
• The practice had signed up to a scheme locally, where community volunteers were rewarded with vouchers. These vouchers could be spent in a number of ways, including on dental care services. The practice accepts these vouchers towards payment for any dental care that incurs a charge.
• The practice could refer complaints to a patient advocate, within the organisation. This ensured that all complaints could be dealt with in an open and transparent way.