Barsar Ltd: Ascot Dental practice

Updated 28 March 2017

We carried out this announced comprehensive inspection on 1 March 2017 to check whether the registered provider was meeting the legal requirements and regulations under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions associated with the Health and Social Care Act 2008.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We informed the NHS England area team that we were inspecting the practice; we received no information from them about the practice.

We reviewed information received from the provider prior to the inspection. During our inspection we reviewed policy documents and spoke with five members of staff, the registered manager/clinical lead, senior head nurse, dentists, hygienists, qualified dental nurses/reception staff. We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. A dental nurse demonstrated how they carried out decontamination procedures of dental instruments.

Thirty four patients provided feedback directly to the inspectors about the service. We also looked at written comments about the practice left about patient experiences on-line via NHS choices. On the day patients were positive about the care they received from the practice. They were complimentary about the friendly, professional and caring attitude of the dental staff. Patients commented that they were likely to recommend the practice.

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 28 March 2017

We carried out an announced comprehensive inspection on 1 March 2017 to 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

London Road Dental Practice (known locally as Ascot Dental Practice) is a small dental practice providing NHS and private dental treatment to patients of all ages. Ascot is a small town in east Berkshire. There are two dental surgeries, one is situated on the ground floor the other surgery is located on the first floor. There is level access from the street. Approximately 2500 patients are registered at the practice.

Wheelchair users or pushchairs can access the practice through step free access. Car parking spaces are available near the practice.

The dental team consists of three dentists, two dental hygienists, three dental nurses/receptionists and one senior head nurse/receptionist. The practice facilities include two treatment rooms, reception and waiting area. The practice is open Monday to Thursday from 9am to 5pm and Friday 9am to 5.30m. The practice will open outside of these hours by arrangement with individual patients. There was an answer phone message directing patients to emergency contact numbers when the practice is closed.

The practice principal/provider is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

The inspection took place over one day and was carried out by a CQC inspector and specialist dental advisor.

We obtained the feedback of three adult patients on the day of our inspection and thirty one patients who had completed comment cards. All patients comment cards and feedback were positive about the care they received from the practice. They were complimentary about the friendly, professional and caring attitude of the dental staff and the dental treatment they had received.

Our key findings were:

• The practice appeared to be clean and well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• The practice had systems in place to manage risks.
• Staff understood and received safeguarding training and knew how to recognise signs of abuse and how to report it.
• Safe recruitment of staff was in place.
• Treatment was well planned and provided in line with current guidelines.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The practice was well-led and staff felt involved and supported and worked well as a team.
• The practice sought feedback from staff and patients about the services they provided.
• Complaints were responded to in an efficient and responsive manner.
• The practice offered a referral for specialist private dental treatment, including implants and orthodontic work. Patients were assessed and referred internally to another dentist within the practice group. The practice offered referrals to NHS specialist dental services should patients require this.

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

• Review the practice’s waste handling policy and procedure to ensure waste is segregated and disposed of in accordance with relevant regulations. Specifically, giving due regard to guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01) in relation to practice waste storage and collection schedules.

• Review the practice’s infection control procedures and protocols. Specifically giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ in relation to water temperatures and that they are recorded during the decontamination process.
• Review the protocols and procedures to ensure staff are up to date with their mandatory training and consider the provision of central records to support staff and their Continuing Professional Development.