Low Fell Caring Dental Practice

Updated 10 January 2019

We carried out this announced inspection on 11 December 2018 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

Low Fell Caring dental practice is in Gateshead, Tyne and Wear and provides predominantly NHS treatment to adults and children. The practice has four treatment rooms. Car parking is available within the premises and on the side-streets near the practice. Step-free access for wheelchair users or people with pushchairs is available.

The dental team consists of the registered provider, practice manager, assisting practice manager, four dentists, two qualified dental nurses (one of whom is also the receptionist) and five trainee dental nurses. The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected one CQC comment card filled in by patients.

During the inspection we spoke with the registered provider, four associate dentists, seven dental nurses and the practice managers. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Tuesday and Thursday 8am to 6pm

Wednesday and Friday 8am to 5.30pm

Saturday 9am to 5pm

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 Glucagon (medicine used for diabetic emergencies) was not stored in accordance with manufacturer’s recommendations.
• The practice had systems to help them manage risk to patients and staff. Risk assessments were not specific to a member of staff where necessary.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures. The process for undertaking Disclosure and Barring Service checks or an adequate risk assessment for not doing so needed to be reviewed.
• 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. A closed-circuit television system (CCTV) was in operation; there was no policy or data protection impact assessment in place.
• 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 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 systems for assessing, monitoring and mitigating the various risks within the practice. In particular, risk assessments should be undertaken in circumstances where a DBS check is not carried out, and should be carried out specific to the employee for those who cannot demonstrate immunity to the Hepatitis B vaccination.
• Review the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
• Review the practice’s protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.
• Review the storage of Glucagon medicine in the practice taking into account the guidelines issued by the manufacturer.
• Review the practice’s protocols for referrals, to ensure they are monitored adequately and are dealt with in a timely manner.