The Care Quality Commission
  • Dentist
  • Dentist

Peachcroft Dental Practice

Suite 4 Peachcroft Shopping Complex, Peachcroft Road, Abingdon, Oxfordshire, OX14 2NA (01235) 532672

Provided and run by:
Arkh-View Surgeries Limited

All Inspections

04/08/2020

During an inspection looking at part of the service

We undertook a follow-up desk based focused review of Peachcroft Dental Practice on 4 August 2020.

This review was carried out to review, in detail, the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The review was carried out by a CQC inspector who had remote access to a specialist dental adviser.

We undertook a comprehensive inspection of Peachcroft Dental Practice on 2 October 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well-led care and was in breach of Regulations 15, 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Peachcroft Dental Practice on our website www.cqc.org.uk.

When one or more of the five questions are not met, we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

This desk-based review was undertaken during the Covid 19 pandemic. Due to the demands and constraints in place because of Covid 19 we reviewed the action plan and asked the provider to confirm compliance after a reasonable interval, focusing on the area where improvement was required.

As part of this inspection we asked:

  • Is it safe?
  • Is it well-led?

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 2 October 2019.

Background

Peachcroft Dental Practice is in Abingdon and provides NHS and private treatment to adults and children.

Car parking spaces, including spaces for blue badge holders, are available, in a public car park, at the front the practice.

The practice is based on the first floor above a retail business. New patients are advised of the stairs when they make contact with the practice.

The dental team includes four dentists, one receptionist and five dental nurses (two which are also the assistant practice manager and practice manager).

The practice has four treatment rooms of which three are in use.

The practice is owned by a partnership 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.At the time of inspection, the practice manager was going through the application process to become the registered manager.

The practice is open:

Monday to Friday 9.00am to 1.00pm and 2.00pm to 5.00pm.

Our key findings were:

  • Systems and processes were put in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk.

  • Recruitment procedures were established to ensure only fit and proper persons are employed.

02/10/2019

During a routine inspection

We carried out this announced inspection on 2 October 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 not 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 not providing well-led care in accordance with the relevant regulations.

Background

Peachcroft Dental Practice is in Abingdon and provides NHS and private treatment to adults and children.

Car parking spaces, including spaces for blue badge holders, are available, in a public car park, at the front the practice.

The practice is based on the first floor above a retail business. New patients are advised of the stairs when they make contact with the practice.

The dental team includes four dentists, one receptionist and five dental nurses (two which are also the assistant practice manager and practice manager)

The practice has four treatment rooms of which three are in use.

The practice is owned by a partnership 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. At the time of inspection there was no registered manager in post as required as a condition of registration.

On the day of inspection, we collected 24 CQC comment cards filled in by patients and obtained the views of 14 other patients.

During the inspection we spoke with two dentists, two dental nurses, one receptionist and the practice manager.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 9.00am to 1.00pm and 2.00pm to 5.00pm.

Our key findings were:

  • The practice appeared clean but not well maintained.
  • The provider had infection control procedures which reflected published guidance.
  • The provider had systems to help them manage risk to patients and staff, but these were not effective.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had staff recruitment procedures, but improvements were needed.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect.
  • Not all of the appropriate medicines and life-saving equipment were available.
  • Staff provided preventive care and supported patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • Staff felt involved and supported and worked well as a team.
  • The provider did not ask patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • The provider had information governance arrangements, but improvements were needed.
  • The practice did not have effective clinical and management leadership.

We identified regulations the provider was not complying with. They must:

  • Ensure all premises and equipment used by the service provider is fit for use. In particular, X-ray units, compressor, treatment room chairs and flooring, fire, gas and electricity installations.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. Specificity management of COSHH, sharps, NHS prescription pad security, radiography, dental care record security, emergency medicines and equipment, staff appraisal and patient feedback.
  • Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

Full details of the regulations the provider is not meeting are at the end of this report.

There were areas where the provider could make improvements. They should:

  • Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.

  • Take action to ensure the service takes into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010. Specifically, arrangements to support patients who experience sight or hearing loss.

  • Implement systems for the recognition, diagnosis and early management of sepsis.

  • Take action to ensure the availability of an interpreter service for patients who do not speak English as their first language.

  • Take action to ensure the regulated activities at Peachcroft Dental Practice are managed by an individual who is registered as a manager.

14/04/2016

During a routine inspection

We carried out an announced comprehensive inspection on 14 April 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

Peachcroft Dental Practice is a dental practice providing NHS and private treatment for both adults and children. The practice is situated in Abingdon, a town south of Oxford.

The practice has four dental treatment rooms and a separate decontamination room used for cleaning, sterilising and packing dental instruments. The practice is based on the first floor of a retail shopping centre.

The practice employs four dentists, a hygienist, five dental nurses of whom three are trainees, two reception staff and a practice manager.The practice’s opening hours are 9am to 1pm and 2pm to 5pm Monday to Friday. There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service. The practice has opted out of providing out-of-hours services to their own patients and refers them to South Central Ambulance Service via the NHS 111 service.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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 26 CQC comment cards completed by patients and obtained the view of 11 patients on the day of our inspection.

The inspection was carried out by a CQC specialist dental inspector.

Our key findings were:

  • We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.

  • Strong and effective leadership was provided by an empowered practice manager.

  • Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.

  • The practice appeared clean and well maintained.

  • Infection control procedures were robust and the practice followed published guidance.

  • The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.

  • Staff reported incidents and kept records of these which the practice used for shared learning.

  • 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 recruitment files were organised and complete.

  • Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice manager.

  • Staff we spoke with felt well supported by the practice manager and were committed to providing a quality service to their patients.

  • Information from 26 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

  • The practice reviewed and dealt with complaints according to their practice policy.

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

  • Introduce a system for capturing national safety alerts such as those issued by the Medicines and Healthcare products Regulatory Agency (MHRA).

  • Consider collating all documents pertaining to dental radiography into one file.

12 September 2014

During an inspection looking at part of the service

When we visited the practice on 7 May 2014, we found patients were not fully protected from the risk of infection because appropriate guidance had not always been followed. We set a compliance action in respect of this. We received an action plan which set out what actions were to be taken, to achieve compliance.

During this inspection we found the practice had taken effective action and achieved compliance.

During the visit we toured the practice and found the surgeries were clean and tidy. The infection control policy was now kept behind the reception area in a folder, and this was accessible to all staff members. The practice manager had devised checklist infection control protocols and these were displayed in treatment rooms. We found the procedures were in date and reflected current professional guidance.

A staff member demonstrated the process for cleaning dental equipment in the decontamination room. We saw during the process the staff member wore appropriate personal protective clothing at all stages of the process. We saw the personal protective equipment (PPE) was disposed of appropriately.

7 May 2014

During an inspection looking at part of the service

We undertook a follow up inspection of this service to review the areas of concern identified in September 2013. We did not speak with patients during our visit as it was not appropriate to do so.

During this inspection we found the provider had appointed an infection control lead and put in place an action plan to address the findings from the previous inspection. We saw a new infection control policy had been written and reviewed, equipment had been repaired or replaced, clinical waste was being disposed of safely and the water quality had been assessed. In addition audits of infection control and hand washing had been implemented.

Despite the improvements we identified further concerns in relation to the control and risk of infection. For example, we observed the incorrect disposal of used personal protective equipment (PPE). There were areas of one surgery with dust behind boxes and staining on the cabinets and the floor in one surgery was damaged.

The provider had put in place a comprehensive schedule of audits to support them to identify and assess risks to the health, safety and welfare of patients who used the services. In addition audits to assess the quality of clinical work had been implemented. As a result of audits the practice had been responsive and had implemented actions to improve for example the quality of x-rays and hand washing. The provider had made significant improvement in this area of quality assurance.

5 September 2013

During a routine inspection

During our visit to Peachcroft Dental Practice we met with the registered manager. We spoke with four members of staff. We spoke with seven patients and looked at seven patient records.

All of the patients we spoke with were very happy with the dental treatment they received. One patient told us 'everyone is so nice and friendly and helpful here'. Another patient said 'he [the dentist] gave me the options, we discussed it'. We looked at patient records which confirmed the treatment patients said they had received.

Staff told us they were supported to carry out their roles. We saw that staff received training specific to their job. We saw that staff received an annual appraisal.

The practice did not operate processes, and followed procedures, that minimised the risk and spread of infection because current guidelines had not been followed.

The practice had systems in place to seek and act on patient feedback and respond to patient complaints. However the practice did operate systems to regularly assess the quality of clinical work and records. The practice also did not effectively operate systems to identify, assess and manage risks relating to the health and safety of patients.