We carried out an announced comprehensive inspection on 10 March 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 not 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
Trenton Dental practice is situated in the Anlaby area of Hull, North Humberside and is situated over two floors. Both surgeries are located on the ground floor of the practice. There are three dentists, an area manager and three dental nurses (two of whom are trainees).
The practice offers a mix of NHS and private dental treatments including preventative advice and routine restorative dental care.
The practice is open:
Monday, Tuesday & Wednesday 09:00 – 17:00
Thursday 09:00 – 16:00
Friday 09:00 – 14:00
The practice owner 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.
We did not receive any completed CQC comment cards and only spoke to one patient on the day of the inspection. They were happy with the care and treatment they had received in the practice and said it was always clean and tidy.
Our key findings were:
- Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it.
- There was not sufficient numbers of suitably qualified staff to meet the needs of patients.
- Some staff had been trained to manage medical emergencies.
- Infection control procedures were in accordance with the published guidelines.
- Patient care and treatment was planned and delivered in line with evidence based guidelines, best practice and current regulations.
- Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
- Patients were treated with dignity and respect and confidentiality was maintained.
- The appointment system met patients’ needs.
- There was a complaints system in place. Staff recorded complaints and cascaded learning to staff.
- The governance systems were not fully effective.
- The practice sought feedback from staff and patients about the services they provided.
We identified regulations that were not being met and the provider must:
- Review the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held, in particular Disclosure Baring Service checks (DBS).
You can see full details of the regulation not being met at the end of this report.
There were areas where the provider could make improvements and should:
- Review the storage of dental care products and medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.
- Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to the guidelines issued by the British Endodontic Society.
- Review the practice responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and ensure all documentation is up to date in regards to risk assessments and staff understand how to minimise risks associated with the use of and handling of these substances.
- Review the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure they are stored securely and disposed of appropriately.
- Review the process to ensure staff are up to date with their mandatory training and their Continuing Professional Development (CPD).
- Review the practice’s process for the auditing of X-rays to ensure they are undertaken at regular intervals to help improve the quality of service.