Madeley Dental Practice

We carried out this announced inspection on 26 November 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 Care Quality Commission, (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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive 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.

Background

Madeley Dental Practice is in Telford, Shropshire and provides NHS and private dental care and treatment for adults and children. The services are provided under three separately registered providers at this location. This report only relates to the provision of general dental care provided by Madeley Dental Practice. Additional reports are available in respect of the general dental care services which are registered under Madeley Practice Limited and Portman Healthcare Limited.

There is level access through automatic doors to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available in the large practice car park at the rear of the building.

The clinical team includes 11 dentists (one is an endodontist, one is an implantologist and three are orthodontists), three dental hygienists, 16 dental nurses and two decontamination nurses. The clinical team are supported by the practice manager, the assistant practice manager, two office administrators and six receptionists. The practice has 11 treatment rooms and a patient consultation room.

The practice is owned by a partnership and as a condition of registration must have a person registered with the CQC 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. A registered manager is legally responsible for the delivery of services for which the practice is registered. The previous registered manager had been cancelled on the 29 October 2019 and the new registered manager was unable to attend their registration interview with CQC due to unforeseen circumstances. The provider had plans in place to register a manager.

On the day of inspection, we collected 12 CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, three dental nurses, one dental hygienist, two receptionists, one office administrator, the assistant practice manager, the area compliance lead 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 from 8am to 5.30pm

Tuesday from 8am to 6pm

Wednesday from 8am to 5.30pm

Thursday from 8am to 5.30pm

Friday from 8am to 5.30pm

Saturday from 9am to 12.30pm

Our key findings were:

• Strong and effective leadership was provided by the practice manager and assistant manager. Staff felt involved and supported and informed us this was a good place to work.
• The provider had infection control procedures which reflected published guidance.
• The practice appeared to be visibly clean and well-maintained. An external company was contracted to provide this service and cleaning schedules were maintained to monitor this.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The provider had systems to help them manage risk to patients and staff. We found that the practice had not ensured that X-ray equipment had been serviced annually, this was immediately scheduled following our visit for January 2020.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures which reflected current legislation.
• 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 provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs. Specialist services such as endodontics, dental implants, periodontics and orthodontics were available at this practice. This enabled patients to receive more advanced treatments in surroundings they were familiar with and reduced waiting times for these complex treatments.
• Due to being part of a corporate organisation the practice was supported further by staff based at their head office ‘The Port’.
• The provider had effective leadership and a culture of continuous improvement. Clinical audit was being completed however the outcomes were not fedback to clinicians.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently. Additional support was available from the group’s internal complaints lead.
• The provider had information governance arrangements.

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

• Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.

• Improve the practice's systems for checking and monitoring equipment taking into account relevant guidance and ensure that all equipment is well maintained. In particular, ensuring X-ray equipment is serviced in accordance with manufacturers guidance.

• Improve the practice protocols regarding clinical audit to ensure that audit outcomes are fedback to clinicians to share learning and drive improvement.