Archived: Tooth Booth Datchet

Updated 11 August 2016

We carried out an announced, comprehensive inspection on 12 July. Our inspection was carried out by a lead inspector and a dental specialist adviser.

During our inspection visit, we reviewed policy documents and staff training and recruitment records. We spoke with five members of staff.

We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. We were shown the decontamination procedures for dental instruments and the computer system that supported the patient dental care records. We reviewed CQC comment cards completed by patients and obtained the view of 13 patients on the day of our inspection.

Patients gave positive feedback about their experience 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 11 August 2016

We carried out an announced comprehensive inspection on 12 July 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

Tooth Booth operates from commercial premises providing NHS and private dentistry for both adults and children. The practice is situated in Datchet, a village east of Windsor, Berkshire.

The practice is based on the ground and first floor. The ground floor is accessible to wheelchair users, prams and patients with limited mobility. The practice has three dental treatment rooms, two of which are based on the ground floor. The practice has a separate decontamination room used for cleaning, sterilising and packing dental instruments.

The practice employs two dentists, one receptionist and three dental nurses, of which two are trainees and the third is also the practice manager.The practice opens Monday, Wednesday, Thursday and Friday from 8:30am to 1pm and 2pm to 6pm. Tuesday from 8:30am to 1pm and 2pm to 7pm and Saturday from 8:30am to 4pm.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. This is provided by an out-of-hours service. If patients called the practice when it was closed an answerphone message gives the telephone number patients should ring depending on their symptoms.

The practice manager is the registered manager. This person was responsible for two practices owned by the provider. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.

During our inspection we reviewed nine CQC comment cards completed by patients and obtained the view of 13 patients on the day of our inspection.

The inspection was carried out by a lead inspector and a dental specialist adviser.

Our key findings were:

• We found that the practice provided patient centred dental care in a relaxed and friendly environment.
• Staff had been trained to handle emergencies and appropriate medicines were available according to current guidelines and most of the life-saving equipment detailed in the Resuscitation Council UK guidelines was readily available.
• The practice appeared clean.
• Infection control procedures followed published guidance.
• The practice had processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a process in place for the reporting of untoward incidents that occurred in the practice. Although the system for shared learning resulting from these incidents could be improved.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff we spoke with were committed to providing a quality service to their patients.
• Information from nine completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.
• Aspects of the governance systems of the practice required strengthening this included procedures and protocols and the written policies underpinning them.

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

• Review the storage of dental care records to ensure that records could be retrieved in a timely manner.
• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK).
• Provide an annual statement about the practice’s infection control systems and processes giving due regard to the Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections’ and related guidance.
• Review the Continuing Professional Development (CPD) of staff in relation to safeguarding training for children and adults.
• Review the processes for shared learning following incidents and accidents occurring in the practice so that they are shared with all members of staff in a timely way.
• Review the practice’s infection control policy to include how the practice meets the requirements of the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the availability of a thermometer for ensuring that the temperature of the water used for manual scrubbing is below the recommended temperature of 45 degrees for this procedure.
• Review the storage of products identified under the Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure they are stored securely.
• Review the systems that are in place to meet health and safety regulations with respect to fire; including the maintenance of emergency lighting, fire drills and fire signage.
• Review the practice's recruitment policy and procedures to ensure that they are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.
• Consider the introduction of a system for collating the records of training, learning and development needs of staff members.