We carried out an announced comprehensive inspection on 1 September 2015 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 not providing well-led care in accordance with the relevant regulations
Background
1A Dental Practice - City provides primary dental care and treatment to patients whose care is funded through the NHS and to a small number of patients who pay privately. The service is part of the 1A Group Dental Practice Partnership owned by a large provider of dental care, the IDH Group currently rebranding to Mydentist. The practice employs five dentists, two dental nurses, a hygiene therapist, three trainee dental nurses (one of whom had completed training and were waiting to register) a practice manager and a receptionist. The practice opens 8.30am to 5pm Monday to Friday.
The practice manager is the registered manager. 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.
We received feedback from 14 patients either in person or via CQC comments cards from patients who had visited the practice in the two weeks before our inspection. They told us staff were welcoming, professional and treated them with dignity and respect. Patients told us they were happy with the care and treatment they received and several patients told us they would recommend the service to friends and family.
Our key findings were:
- A process was in place for identifying, reporting and investigating incidents and accidents. Improvement was needed to ensure that each stage of the process was completed so that risks could be managed by taking appropriate action.
- Staff had received safeguarding and whistleblowing training and knew the processes to follow to raise any concerns.
- There were sufficient numbers of suitably qualified staff to meet the needs of patients.
- Staff had been trained to handle emergencies; appropriate medicines and life-saving equipment were readily available.
- Infection control procedures were in place and the practice followed published guidance on the majority of occasions, however, there were some areas for improvement.
- Patient care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
- 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 the needs of patients and waiting times were kept to a minimum.
- There was an effective complaints system and the practice was open and transparent with apologies given if a mistake had been made.
We identified regulations that were not being met and the provider must:
- Ensure improvement is made to the procedures for reporting, recording and analysing incidents and accidents so that appropriate action is taken to reduce the risk of further occurrences.
- Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’
- Review the local rules for the operation of X-ray equipment to ensure that it is only operated by clinical staff authorised to carry out X-ray procedures.
You can see full details of the regulations not being met at the end of this report.
There were areas where the provider could make improvements and should:
- Review the training for the infection control lead so that they have the appropriate knowledge and skills to fulfil the role and are supported to complete monitoring tasks.
- Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
- Review the ground floor access to the practice for patients with a disability ensure that staff recognise and report concerns and complaints raised by patients.
- Follow the full recruitment policy when new staff are appointed
- Complete a risk assessment to safely manage the open access to the staircase in the staff room so that adequate control measures are put in place to prevent accidents.
- Complete the actions following the fire risk assessment so that all risk reduction measures are in place.