Archived: Lovat House Dental Surgery

Updated 16 May 2017

We carried out an announced, comprehensive inspection 28th March 2017. The inspection was led by a CQC inspector who was accompanied by a dental specialist advisor.

We reviewed information received from the provider before the inspection. During our inspection visit, we met with the two receptionists, a dental nurse, one hygienist and the dentist who was also the registered provider for the practice. A registered provider is a ‘registered person’ who has legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Before the inspection we looked at the NHS Choices website but there had been no reviews in the past year.

We also contacted NHS England and Healthwatch. We received no information from NHS England or Healthwatch about the practice.

We reviewed policy documents and dental care records. We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. We observed a dental nurse carrying out decontamination procedures of dental instruments and also observed staff interacting with patients in the waiting area.

Fourteen people provided feedback about the service. Patients, who completed comment cards, were positive about the care they received from the practice. They were complimentary about the skilful, friendly and caring attitude of the dental staff.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 16 May 2017

We carried out an announced comprehensive inspection on 28th March 2017to 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

Lovat House Dental Practice is located in the centre of Cheltenham and provides private treatment to adults and children. The practice consists of four treatment rooms, toilet facilities for patients and staff, a reception area and waiting area.

The practice offers routine examinations and treatment. There is one dentist, who is also the registered provider, two dental hygienists, two dental nurses and two receptionists. This provider shares the facilities in the practice with two other dentists who are also registered separately as providers.

The practice’s opening hours are

Monday to Thursday 8am to 1pm and 2pm to 5pm

Alternate Fridays 8.30am to 12noon

Out of hours the three dentists took turns to be on-call and patients were directed to phone the dentist on-call.

We carried out an announced, comprehensive inspection on 28th March 2017. The inspection was led by a CQC inspector who was accompanied by a specialist dental advisor.

For this inspection 14 people provided feedback to us about the service. Patients were positive about the care they received from the practice. They were complimentary about the service offered, which they said was most satisfactory, ten out of ten and excellent. They told us that staff were skilful, kind, helpful, caring, respectful and friendly and the practice was clean and hygienic.

Our key findings were:

• Safe systems and processes were in place, including a lead for safeguarding. However, attention was needed to some of the fire safety measures.

• Staff recruitment needed to be improved because relevant checks had not been conducted for the most recent person employed. Staff received relevant training.

• The practice had ensured that some risk assessments were in place. We found that there was no Legionella risk assessment and the fire risk assessmenthad not been carried out by appropriately qualified people.

• The clinical equipment in the practice was appropriately maintained. The practice appeared visibly clean throughout although parts of the surgery were cluttered.

•The process for decontamination of instruments followed relevant guidance.

• The practice maintained appropriate dental care records and patients’ health details were updated. We found some clinical details were not always recorded.

• Patients were provided with health promotion advice to promote good oral care.

• Consent was obtained for dental treatment.

• The dentist was not aware of the process to follow when a person lacked capacity to give consent to treatment.

• There were arrangements for governance at the practice such as systems for auditing infection control and radiographs.

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

• Review the recruitment procedures to ensure that Disclosure and Barring Service (DBS) and references are obtained before new staff start work in the practice in line with current guidance.

• Review the arrangements for support to staff to make sure all staff receive regular appraisals and personal development plans.

• Review the arrangements for fire safety to make sure the fire safety measures are in place, including a fire risk assessment.

Review the arrangements for prevention of Legionella.

• Review the layout of the surfaces and cupboards in the surgery and the room with the X-ray developer to make sure they are clutter free and easy to clean.

• Review the storage of paper records to make sure that patient records are stored securely to ensure confidentiality.

• Review the arrangements for communication to include a hearing loop for patients with a hearing impairment and access to a translation service for people whose first language is not English.

• Review the arrangements for obtaining patient feedback to make sure questionnaires are reviewed at regular intervals and improvements are identified as a result of feedback.

• Review the arrangements for auditing to make sure the infection control audits are more in depth and include action plans and learning outcomes.