Castle Dental Care

We carried out this announced inspection on 18 June 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

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 form the framework for the areas we look at during the inspection.

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

Castle Dental Care is in Birmingham and provides NHS and private treatment to adults and children.

The practice is on the first floor but there is level access for people who use wheelchairs and those with pushchairs. There is lift access to the first floor. Car parking spaces, including several bays for blue badge holders, are available near the practice.

The dental team includes eleven dentists, 12 dental nurses (one of whom is a trainee dental nurse), one dental hygiene therapist and two receptionists. There is also a practice manager and a deputy manager (both of whom are qualified dental nurses). The practice has eight treatment rooms and two separate rooms for carrying out decontamination.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Castle Dental Care is the practice manager. One of the partners was on maternity leave at the time of our visit but attended the inspection and contributed throughout our visit.

On the day of inspection, we collected 50 CQC comment cards filled in by patients.

During the inspection we spoke with six dentists, four dental nurses, two receptionists, the deputy manager and the registered manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Mondays and Tuesdays – 9am to 5.30pm

Wednesdays and Thursdays – 8.30am to 5pm

Fridays – 8.30am to 4.30pm

The practice closes for lunch every day and details of this are on the practice website.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular, ensuring all intra-oral X-ray machines are fitted with rectangular collimators to reduce the radiation exposure to patients.