Argo Practices Shrewsbury

Updated 6 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 9 August 2016 and was led by a CQC inspector and supported by a specialist dental advisor. Prior to the inspection, we reviewed information we held about the provider. We asked the practice to send us some information that we reviewed. This included the complaints they had received in the last 12 months, their latest statement of purpose, and the details of their staff members including proof of registration with their professional bodies.

During our inspection we toured the premises; we reviewed policy documents and staff records and spoke with four members of staff, including the registered manager. We looked at the storage arrangements for emergency medicines and equipment. We were shown the decontamination procedures for dental instruments and the computer system that supported the dental care records.

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 6 October 2016

We carried out an announced comprehensive inspection on 9 August 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

Argo Dental Practice has four dentists who work part time, two dental hygienists and one dental therapist, two qualified dental nurses who are registered with the General Dental Council (GDC) and two apprentice dental nurses, a practice manager, and two receptionists. The practice’s opening hours are 9am to 5pm on Monday, 8am to 5pm on Tuesday and Friday, 8am to 6pm Wednesday and 8am to 8pm on a Thursday.

Argo Dental Practice provides private dental treatment for adults and children. The practice has four dental treatment rooms on the ground floor and a separate decontamination room for cleaning, sterilising and packing dental instruments. There was also a reception and waiting area.

The registered manager was present during this inspection. 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.

Before the inspection we sent Care Quality Commission comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received feedback from ten patients who provided an overwhelmingly positive view of the services the practice provides. All of the patients commented that the quality of care was good.

Our key findings were

• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Feedback from patients was positive. Patients said they were treated with dignity and respect.
• The practice was visibly clean and well maintained.
• Infection control procedures were in place with infection prevention and control audits being undertaken on a six monthly basis. Staff had access to personal protective equipment such as gloves and aprons.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Patients’ confidentiality was maintained.
• Dentists identified treatment options and these were discussed with patients.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns.
• Staff had been trained to deal with medical emergencies, although update training was required which had been booked for September 2016.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• Governance arrangements were in place for the smooth running of the practice and there was a structured plan in place to audit quality and safety beyond the mandatory audits for infection control and radiography.

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

• Review the practice’s policy and procedures for accident reporting and develop a policy in relation to duty of Candour.

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review availability of staff training to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the suitability of the decontamination room in relation to the availability of separate hand wash facilities.
• Review the practice’s risk assessment processes.
• Review the current legionella risk assessment and implement the required actions.
• Review compliance with the legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.
• Review the practice’s audit protocols of various aspects of the service and ensure audits have documented learning points and the resulting improvements can be demonstrated.