Together Dental Canvey Island

Updated 23 February 2017

The inspection was carried out on 13 December 2016 and was led by a CQC inspector. The inspection team also included a professional dental specialist advisor.

The methods that were used to collect information at the inspection included interviewing staff, observations and reviewing documents.

During the inspection we spoke with three dentists, two dental nurses, two receptionists and four patients. We reviewed the comments made by four patients who we spoke with during the inspection and 22 patients who completed CQC comment cards.

We reviewed policies, procedures 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 23 February 2017

We carried out an announced comprehensive inspection on 13 December 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

Elder Tree Dental Practice is a dental practice situated in a converted property on Canvey Island, Essex. The practice has four treatment rooms, two waiting rooms and a reception area. Decontamination takes place within treatment a dedicated decontamination room (Decontamination is the process by which dirty and contaminated instruments are bought from the

treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

The practice offers NHS and private general and cosmetic dental treatments to adults and children.

The opening hours of the practice are 9am to 5.30pm Monday to Thursday. Appointments are available from 9am to 1pm and 2pm to 5.15pm. The practice is open between 9am and 5pm on Fridays and appointments are available up to 4.45pm. Evening appointments are available up to 7.30pm on Monday or Tuesday evenings and the practice is open between 9am and 1pm on alternate Saturdays. Emergency walk in appointments for urgent treatment are available each day between 11am and 12pm. The practice closes between 1pm and 2pm for lunch.

The practice has a principal dentist, four associate dentists, four dental nurses and two receptionists.

The practice is registered with the Care Quality Commission (CQC) as an individual. The principal dentist is the ‘registered person’. 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 received feedback from 22 patients who completed CQC comment cards prior to our inspection visit. We also spoke with four patients during the inspection visit. Patients made positive comments about the excellent care and treatment that they received. They also commented positively about the cleanliness of the premises, the kindness and responsiveness of staff. Patients said that staff explained treatment plans to them in a way that they could easily understand.

Our key findings were:

• The practice had systems in place for investigating and learning from complaints, safety incidents and accidents. Staff were aware of their responsibilities to report incidents.
• The practice was visibly clean and clutter free. Infection control practices were reviewed and audited to test their effectiveness.
• There were systems in place to help keep people safe, including safeguarding vulnerable children and adults. Staff had undertaken training and were aware of their roles and responsibilities in relation to this.
• Risks to the health, welfare and safety of patients and staff were regularly assessed and managed. These included risks in relation to fire, legionella and risks associated with premises and equipment.
• The practice reviewed and followed guidance in relation to dentistry. However we found that dentists did not routinely use a rubber dam as recommended to protect patient’s airways when carrying out root canal treatment.
• The practice had the recommended medicines and equipment for use in the event of a medical emergency and staff were trained in their use. Records were maintained in respect of the checks carried out for these medicines and equipment.
• Staff were supported, supervised and undertook training in respect of their roles and responsibilities within the practice.
• Patients reported that they were treated with respect and that staff were polite and helpful.
• Patients were involved in making decisions about their care and treatments.
• Effective governance arrangements were in place for the smooth running of the service.
• Audits and reviews were carried out to monitor and improve services. Learning from audits and reviews was shared with relevant staff and action plans were developed to secure improvements where these were identified.
• Patient’s views were sought and these were used to make improvements to the service where these were identified.

There was an where the provider could make improvements and should:

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.