Archived: St James's Square Dental Surgery

We carried out this announced inspection on 27 November 2017 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.

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 not 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 not providing well-led care in accordance with the relevant regulations.

Background

St James’ Square Dental practice is located on St James' Square within a building close to the town centre. It provides private treatment to patients of all ages.

There is level access for patients who use wheelchairs and pushchairs. The practice has car parking spaces behind the practice.

The dental team consists of a locum dentist, a locum hygienist, an agency dental nurse and a receptionist. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist. 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 spoke with three patients. This information gave us a positive view of the practice.

During the inspection we spoke with the locum dentist, the agency dental nurse, the receptionist and the principal dentist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Thursday 8.00am – 4.30pm

• Friday 8.00am – 4.00pm
• Out of hour’s information displayed on website and via telephone answering service.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which mostly reflected published guidance.
• Staff had not received any recent training in how to deal with medical emergencies and did not have all the appropriate medicines and life-saving equipment available.
• The practice had some systems to help them manage risk but they were not robust or operated effectively.
• The practice had safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Not all staff had received safeguarding training to the required level.
• The practice recruitment procedures did not meet the legislative requirements for the safe recruitment of staff.
• 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 limited leadership which was not wholly effective and did not ensure staff completed all required continuing professional development through appraisal.
• Locum staff told us they felt supported in their work.
• The practice had not asked staff and patients for feedback about the services they provided.
• The practice had an appropriate complaint process.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure all premises and equipment used by the service provider is fit for use
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• Ensure specified information is available regarding each person employed

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Put into place systems for monitoring and updating staff training

  We carried out this announced inspection on 27 November 2017 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.

  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 not 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 not providing well-led care in accordance with the relevant regulations.

  Background

  St James’ Square Dental practice is located on St James' Square within a building close to the town centre. It provides private treatment to patients of all ages.

  There is level access for patients who use wheelchairs and pushchairs. The practice has car parking spaces behind the practice.

  The dental team consists of a locum dentist, a locum hygienist, an agency dental nurse and a receptionist. The practice has two treatment rooms.

  The practice is owned by an individual who is the principal dentist. 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 spoke with three patients. This information gave us a positive view of the practice.

  During the inspection we spoke with the locum dentist, the agency dental nurse, the receptionist and the principal dentist. We looked at practice policies and procedures and other records about how the service is managed.

  The practice is open:

• Monday to Thursday 8.00am – 4.30pm
• Friday 8.00am – 4.00pm
• Out of hour’s information displayed on website and via telephone answering service.

• Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which mostly reflected published guidance.
• Staff had not received any recent training in how to deal with medical emergencies and did not have all the appropriate medicines and life-saving equipment available.
• The practice had some systems to help them manage risk but they were not robust or operated effectively.
• The practice had safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Not all staff had received safeguarding training to the required level.
• The practice recruitment procedures did not meet the legislative requirements for the safe recruitment of staff.
• 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 limited leadership which was not wholly effective and did not ensure staff completed all required continuing professional development through appraisal.
• Locum staff told us they felt supported in their work.
• The practice had not asked staff and patients for feedback about the services they provided.
• The practice had an appropriate complaint process

• We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

• Ensure all premises and equipment used by the service provider is fit for use
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• Ensure specified information is available regarding each person employed.

• Full details of the regulations the provider was not meeting are at the end of this report.

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

• Put into place systems for monitoring and updating staff training.