Updated 2 September 2019
We carried out this announced inspection on 13 August 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
Bulwell House Dental Practice is in the Bulwell area of Nottingham and provides NHS and private dental treatment to adults and children.
The dental team includes three dentists, five dental nurses including three trainees, two receptionists and a practice manager. The practice has three treatment rooms and an instrument decontamination room. One of the treatment rooms is located on the ground floor. There is level access into the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice on local roads and car parks. There is parking space available at the rear of the practice for blue badge holders and those with restricted mobility.
The practice is owned by an organisation 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 Bulwell House Dental Practice is the practice manager.
On the day of inspection, we collected ten CQC comment cards filled in by patients.
During the inspection we spoke with two dentist, three dental nurse, two receptionists, the practice manager and a manager from the provider’s organisation. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday: 8am to 5.30pm, Tuesday: 8am to 8pm, Wednesday: 8am to 5.30pm, Thursday: 8am to 8pm, Friday: 8.30am to 5.30pm and Saturday: 9am to 1pm
Our key findings were:
- The practice appeared clean and well maintained.
- The provider had infection control procedures which reflected published guidance, apart from the completion of six-monthly infection prevention and control audits.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider 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.
- Improvements were needed to the system for assessing materials and substances that are hazardous to health.
- 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 provided preventive care and supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and 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 policy for the control of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure appropriate risk assessments are undertaken.
- Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’. In particular in relation to six-monthly audits and action plans where required, and the availability of specific items of personal protective equipment.