Updated 12 June 2017
We carried out this announced inspection on 3 May 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We previously carried out an inspection in January 2016 and the purpose of this inspection was to also follow up on the two requirement notices served for good governance and staffing. 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.
We carried out a comprehensive inspection at this service on the 19 January 2016 where we found breaches of our regulations in Regulation 17 good governance and Regulation 18 staffing and requirement notices were served. The main areas of concern highlighted were; infection control, staff support, fire safety and clinical audit.
We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information.
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
Yeovil Dental Practice is in Yeovil, Somerset and provides approximately 80% NHS and 20% private treatment to patients of all ages.
The practice is a listed building with uneven levels and narrow staircases. The front entrance is not accessible for wheelchair users and so there is an access lift outside the building and a concrete ramp for disabled access into the back of the building. There are also two accessible spacious surgeries on the ground floor. There is a small car park with limited spaces with one disabled parking bay. There are local public car parks and transport nearby.
The dental team includes five dentists, two trained dental nurses (one of which is the practice manager), seven trainee dental nurses, one dental hygienist and two receptionists. The practice has five treatment rooms.
The practice is owned by a Rodericks Dental Limited 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 the inspection the practice did not have a registered manager in post.
On the day of inspection we collected six CQC comment cards filled in by patients and spoke with four other patients. This information gave us a positive view of the practice.
During the inspection we spoke with all five dentists, six dental nurses and two receptionists, the practice manager and area manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
- Monday, Wednesday and Friday 8:30am to 5pm
- Tuesday and Thursday 8:30am to 7pm
- The first Saturday of each month from 9am to 12pm
Our key findings were:
- The practice appeared clean and well maintained.
- The practice had infection control procedures which reflected published guidance. However, they still needed to ensure they had adequate ventilation in the decontamination room.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment was available.
- The practice had systems to help them manage risk, such as fire safety, health and safety and legionella.
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
- 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.
- The appointment system met patients’ needs.
- The practice had effective leadership and management. Staff felt involved, well supported and worked well as a team.
- The practice asked staff and patients for feedback about the services they provided.
- The practice dealt with complaints positively and efficiently.
- The practice had adequate staff recruitment procedures. Risk assessments had not always been undertaken when key documentation, such as references had not been received prior to commencement of the staff member’s employment.
- Policies and procedures needed improvement to be reflective of localised procedures and current legislation.
There were areas where the provider could make improvements. They should:
- Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
- Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.