Updated 23 April 2020
We carried out this announced inspection on 6 March 2020 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 Care Quality Commission (CQC) inspector who was supported by two specialist dental advisers.
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 this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found this practice was providing effective care in accordance with the relevant regulations.
Are services caring?
We found this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found this practice was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
Background
Hallcross Dental Practice is in Wigston, a town in Leicestershire and provides NHS and private dental care and treatment for adults and children. Services include general dentistry, implants and orthodontics.
There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including parking for people with disabilities, are available in the practice car park.
The dental team includes eight dentists, two specialist orthodontists, seven dental nurses, three trainee dental nurses, three dental hygienists and four receptionists. There is also a business manager employed who is qualified as a dental hygienist and works as a treatment co-ordinator. The practice has seven treatment rooms; four are on ground floor level.
The practice is owned by a company and as a condition of registration must have a person registered with the CQC 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 Hallcross Dental Practice is the business manager.
On the day of inspection, we collected 24 CQC comment cards filled in by patients.
During the inspection we spoke with two dentists, three dental nurses, two receptionists and the business manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open: Monday, Tuesday, from 8.15am to 5.30pm, Wednesday from 8am to 5.30pm, Thursday from 8.15am to 7pm and Friday from 8.15am to 5pm.
Our key findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures which reflected published guidance.
- Clinicians completed annual basic life support training; dental nurses were overdue to complete this training. Following our visit, arrangements were made for them to refresh their knowledge.
- Appropriate medicines and life-saving equipment were available. We noted there was an insufficient quantity of syringes and needles, however.
- The provider had most systems to help them manage risk to patients and staff. We identified some areas for review such as fire risk assessment and five-year fixed wiring testing. Measures were taken to address this after our visit.
- The provider had robust and effective safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which reflected current legislation. We noted some information had not yet been obtained for new staff members.
- 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 provided preventive care and supported 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 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 information governance arrangements.
There were areas where the provider could make improvements. They should:
- Take action to ensure all staff have received training to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
- Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. For example, the practice had not ensured that all risks had been effectively managed at the time of our inspection. This included issues such as five year fixed wiring testing, ensuring a comprehensive fire risk assessment was in place, risks relating to the non use of rubber dam and ensuring monitoring systems for NHS prescriptions.