Low Fell Caring Dental Practice

We carried out an announced comprehensive inspection on 08 December 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

Low Fell Caring dental practice is located in Gateshead, Tyne and Wear and provides predominantly NHS treatment to patients of all ages.

There are four treatment rooms spread over two floors, a dedicated decontamination room for sterilising dental instruments, two waiting rooms, a staff kitchen and general office. Car parking is available within the premises and on the side-streets near the practice. Access for wheelchair users or pushchairs is possible via the step-free footpath and driveway at the entrance of the premises.

The practice is open:

Monday, Tuesday and Thursday 0800-1800

Wednesday 0800-1730

Friday 0800-1730

Saturday 0900-1700

The dental team is comprised of the registered provider, practice manger, assisting practice manager, five dentists, three qualified dental nurses (one of whom is also the receptionist) and five trainee dental nurses.

The practice owner is registered with the Care Quality Commission (CQC) as an individual. 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 reviewed 13 CQC comment cards on the day of our visit; patients were very positive about the staff and standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• Staff were very friendly, caring and enthusiastic.
• The practice was visibly clean and an infection prevention and control policy was in place.
• We saw sterilisation procedures followed recommended guidance.
• The practice had systems for recording incidents and accidents.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Patient feedback was regularly sought and reflected upon.
• Patients could access urgent care when required.
• Dental professionals were maintaining their continued professional development (CPD) in accordance with their professional registration.
• Complaints were dealt with in an efficient and positive manner.
• Staff received annual medical emergency training.
• Equipment for dealing with medical emergencies reflected guidance from the resuscitation council.
• Staff were aware on how to escalate safeguarding issues for children and adults should the need arise. Contact details were available within their safeguarding policy.
• The practice managers received safety alerts from the Medicines and Healthcare products Regulatory Agency (MHRA). These were distributed to other dentists and shared amongst all staff within the practice.
• The practice was actively involved in training programmes such as vocational training for qualified dentists and teaching student dental nurses.
• Staff meetings were infrequent.
• Dentists were not using rubber dam for root canal treatment.
• Recruitment procedures were not consistent.
• Dental staff turnover was high.
• Staff were not fully supported in their roles.

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

• Review the practice's recruitment policy and procedures to ensure recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and to ensure necessary employment checks are in place for all staff. This includes ensuring the required specified information in respect of persons employed by the practice is held.
• Review the practice’s procedures for undertaking regular staff satisfaction surveys and staff meetings to help improve the quality of service and review staff turnover.
• Review the practice’s lone working risk assessment to ensure it is specific to the requirements of a particular lone working employee.
• Review the requirements of the Equality Act 2010 and fully assess the barriers which may prevent some people from using their services, for example by undertaking a disability access audit.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
• Review the storage methods for medical emergency drugs including Glucagon (used for diabetic emergencies) to ensure manufacturer’s guidance is followed.
• Review the practice’s audit protocols to document learning points, share with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.