12 May 2021
During an inspection looking at part of the service
We carried out this announced inspection on 12 May 2021 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 an additional CQC inspector and a specialist dental adviser.
As part of this inspection we asked:
• Is it safe?
• Is it effective?
• 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 well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
Background
Tamworth Dental Practice Partnership is in Tamworth, Staffordshire and provides NHS and private dental care and treatment for adults and children.
There was ramped access to the rear of the practice for people who use wheelchairs and those with pushchairs. At the time of our inspection the practice was undergoing a large build project to enhance the facilities for patients, this has resulted in the wheelchair access being temporarily unavailable. Patients who require wheelchair access are signposted to a local sister practice that is fully accessible. Car parking spaces, including dedicated parking for people with disabilities, are available in a pay and display car park opposite the practice. The railway station is less than a five-minute walk from the practice.
The dental team includes 10 dentists, nine dental nurses (seven of whom are trainee dental nurses), four receptionists and a practice manager. The practice has six treatment rooms.
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. A statutory notification advising of changes to a registered manager was submitted to CQC by the provider on the day of our inspection.
During the inspection we spoke with three dentists, three dental nurses (two of whom were trainees), two receptionists 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 to Friday from 8am to 8pm
Saturday from 8am to 3pm
Our key findings were:
- The practice was undergoing extensive renovations and building works at the time of our inspection. The provider had invested in a significant build project to expand services and facilities available to include improved access, additional waiting facilities, three additional treatment rooms, a treatment coordinator consultation room, a digital scanning room, a training suite and additional staff areas.
- Comprehensive procedures had been implemented to reduce the spread of Covid 19.
- Staff told us they felt involved and supported and worked as a team. At the time of our visit we were unable to review any appraisal documents due to many staff members being newly recruited and longer standing team members not receiving them due to the pandemic restrictions and priorities. The provider sent us a copy of their appraisal schedule within 48 hours of the inspection.
- We identified several minor shortfalls during our inspection. However, the provider responded swiftly to these and following our inspection we were sent evidence to demonstrate that many of them had been addressed. This assured us that the provider took our concerns seriously. The provider must ensure that these improvements are embedded and sustained in the long term.
- The provider had infection control procedures which reflected published guidance.
- 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.
- 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 provided preventive care and supported patients to ensure better oral health.
- The provider had effective leadership and a culture of continuous improvement. However, at the time of our inspection the practice did not have a CQC registered manager, a statutory notification to notify CQC of a change to the registered manager was submitted during the inspection.
There were areas where the provider could make improvements. They should:
- Take action to ensure the regulated activities at Tamworth Dental Practice Partnership are managed by an individual who is registered as a manager.
- Develop systems to ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff.
- Improve the practice's protocols for medicines management and ensure all medicines are dispensed safely.
- Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.