Archived: Delapre Dental Care

We carried out this announced inspection on 17 January 2020 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

Delapre Dental Care is in Northampton, a large town in the East Midlands region. It provides mostly NHS and some private dental care and treatments for adults and children. Services include general dentistry and implants.

There is level access to the practice for people who use wheelchairs and those with pushchairs by entry at the rear of the premises. There are some car parking spaces for patients in the practice’s car park.

The dental team includes the principal dentist, two locum dentists, two dental nurses, one trainee dental nurse and one dental hygienist. One of the dental nurses also works as the practice manager.

The practice has two treatment rooms currently in use; both are on ground floor level.

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 10 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, two dental nurses (including the nurse who works as the practice manager) and the trainee dental nurse. We looked at practice policies and procedures, patient feedback and other records about how the service is managed.

The practice is open: Monday to Friday from 9am to 5pm. It closes at lunchtimes for one hour.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff had received training in how to deal with emergencies. Most appropriate medicines and life-saving equipment were available, although we noted some exceptions. These were obtained after the inspection.
• The provider had systems to help them manage risk to patients and staff. We noted some areas that required review to ensure all risks were appropriately mitigated.
• The provider had safeguarding processes and staff showed awareness of their responsibilities for safeguarding vulnerable adults and children. Greater oversight was required by management to ensure staff completed this training.
• The provider had staff recruitment procedures which mostly reflected current legislative requirements.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• We noted that further detail was required in patients’ dental care records when a referral to the hygienist was made.
• Staff had awareness of the Mental Capacity Act 2005, although we found their knowledge could be improved in relation to the application of this, and Gillick competence.
• 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.
• The provider had effective leadership.
• Staff felt involved and supported and worked as a team.
• The provider asked patients for feedback about the services they provided.
• The provider had systems in place to deal with complaints. We saw that this was subject to discussion amongst staff.
• The provider had information governance arrangements.

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

• Improve and develop staff awareness of the application of the Mental Capacity Act 2005 and Gillick competence and ensure all staff are aware of their responsibilities as it relates to their role.

• Improve the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities.
• Improve the practice’s arrangements for ensuring good governance is sustained in the longer term.