Thomas and Wilkinson

Updated 30 January 2017

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 registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection took place on 13 December 2016 and was led by a CQC Inspector with remote access to a dental specialist adviser.

Prior to the inspection we asked the practice to send us some information which we reviewed. This included details of complaints they had received in the last 12 months, their latest statement of purpose, and staff details, including their qualifications and professional body registration number where appropriate. We also reviewed information we held about the practice.

We informed NHS England Cheshire and Merseyside area team that we were inspecting the practice; however we did not receive any information of concern from them.

During the inspection we spoke to three dentists, the practice manager and dental nurses. We reviewed policies, protocols and other documents and observed procedures. We also reviewed CQC comment cards which we had sent prior to the inspection for patients to complete about the services provided at the practice.

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 30 January 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

Aigburth Dental Practice is located in a residential suburb close to the centre of Liverpool. The practice’s reception, a waiting room and two treatment rooms are situated on the ground floor. A further waiting room and three treatment rooms are situated on the first floor. There are patient toilet facilities on both floors. Parking is available on nearby streets.

The practice is accessible to patients with disabilities, impaired mobility, and to wheelchair users.

There are steps at the front entrance to the practice with handrails positioned alongside to assist patients with impaired mobility. At the rear entrance to the practice the provider has a portable ramp available ramp to facilitate access to the practice for wheelchair users.

The practice provides general dental treatment to patients predominantly on a privately funded basis but also on an NHS funded basis. The opening times are Monday 8.30am to 5.30pm, Tuesday and Wednesday 8.00am to 5.30pm, Thursday 8.30am to 7.00pm, Friday 8.30am to 12.30pm and Saturday 9.00am to 2.00pm.

The practice is staffed by three principal dentists, a practice manager/dental nurse, an associate dentist, two dental therapists/hygienists, two dental hygienists and ten dental nurses, two of whom are trainees.The dental nurses also carry out reception duties.

One of the principal dentists 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 49 people during the inspection about the services provided. Patients were markedly positive about all aspects of the care and treatment. Patients commented that they found the practice excellent and that staff were professional, friendly, and caring. They said that they were always given helpful, honest explanations about dental treatment, and that the clinicians listened to them. Patients commented that the practice was clean and comfortable. Treatments were described by patients as excellent and appointments were always easy to obtain.

Our key findings were:

• Staff had received safeguarding training, and knew the processes to follow to raise concerns.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• The premises was clean, secure and well maintained.
• Staff followed current infection control guidelines for decontaminating and sterilising instruments.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect, and their confidentiality was maintained.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.
• The practice did not have procedures in place to record and analyse significant events and incidents but learning from them was shared with staff.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available, with the exception of one medicine which was ordered immediately.

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

• Introduce a system for the recording, investigating and reviewing of incidents and significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review the security of prescription pads in the treatment rooms and ensure there are systems in place to monitor and track their use.
• Review the current Legionella risk assessment regularly having due regard to the 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.