Updated 5 July 2019
We carried out this announced inspection on 17 June 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, a second specialist dental adviser, and a pharmacy manager.
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
Dental Surgery, 20 The Avenue, Gosport known locally as Avenue Dental Care is in Gosport and provides private treatment to adults and NHS treatment to children.
There is no level access for people who use wheelchairs and those with pushchairs as the practice entrance is on the first floor above retail premises. Car parking spaces, including those for blue badge holders, are available near the practice.
The dental team includes one dentist, one lead dental nurse/receptionist, two trainee dental nurses/receptionists, one dental hygienist and one practice manager. The practice has two treatment rooms.
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 22 CQC comment cards filled in by patients and spoke with four other patients.
During the inspection we spoke with one dentist, one lead dental nurse/receptionist, one trainee dental nurse/receptionist, one agency dental nurse and one dental hygienist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday, Wednesday, Thursday 8.30am to 5pm
Tuesday 8.30am to 6pm
Friday 8.30 to 4.30pm
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 mostly available.
- The practice 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.
- 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 were providing preventive care and supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- Improvements could be made to information contained in Control of Substances Hazardous to Health (COSHH) Regulations 2002 file to ensure the safe storage and use of materials used.
- Improvements could be made to the auditing process to ensure that patient care notes are in line with FGDP guidelines.
- Improvements could be made to confirm the accuracy of the legionella risk assessment process.
- The provider should implement the fire risk assessment actions outlined.
- 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 and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.
- Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.
- Review the practice’s protocols to ensure audits of radiography, dental care records and infection prevention and control are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
- Review the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.