Archived: Mrs HM Lloyd Dental Practice

Updated 9 March 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 26 January 2017 and was led by a CQC Inspector assisted by a specialist dental 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 the 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 the dentists, the practice manager, dental nurses and the receptionist. 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 9 March 2017

We carried out an announced comprehensive inspection on 26 January 2017 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

Mrs HM Lloyd Dental Practice is located in a residential suburb and comprises a reception and waiting room, two treatment rooms, one of which is on the ground floor, and a decontamination room. Parking is available on nearby streets. The practice is accessible to patients with disabilities, limited mobility, and to wheelchair users. There are patient toilet facilities on the ground floor. There is one step at the front entrance to the practice with a handrail to assist patients. The provider has a portable ramp available to facilitate access to the practice for wheelchair users.

The practice provides general dental treatment to children on an NHS or privately funded basis, and to adults on a privately funded basis. The opening times are Monday to Friday 9.00am to 5.30pm. The practice is closed for lunch between 1.00pm and 2.00pm.. The practice is staffed by a principal dentist, an associate dentist, a practice manager, a receptionist, and two dental nurses.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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 47 people during the inspection about the services provided. Patients commented that they found the practice excellent and well organised, and that staff were welcoming, friendly, and caring. Several patients commented that staff go out of their way to accommodate their needs and look after them. They said that they were always given good explanations about dental treatment, that the dentists listened to them and treatments were excellent. Patients commented that the practice was clean and comfortable.

Our key findings were:

• The practice had procedures in place to record and analyse significant events and incidents.
• 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.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• The premises and equipment were clean, secure and well maintained.
• Staff followed current infection control guidelines for decontaminating and sterilising equipment.
• 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.

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

• Review the availability of medicines to manage medical emergencies having due regard to guidelines issued by the British National Formulary and the General Dental Council standards for the dental team.
• Review the security of NHS prescriptions in the practice and ensure there are systems in place to monitor and track their use.
• Review the legionella risk assessment and implement the required actions 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.
• Review the practice’s recruitment procedures to ensure checks relating to the employment of staff are in place, and accurate, complete and detailed records of these are maintained.
• Review the protocols and procedures to ensure staff are up to date with their mandatory training and their continuing professional development, specifically in relation to life support and medical emergencies training and safeguarding training.
• Review the practice’s audit protocols to ensure infection control auditing is in accordance with current guidelines.