All inspections: Tregenna Hill Dental Surgery

We carried out an announced comprehensive inspection on 6 April 2016 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

Tregenna Hill Dental Surgery is located in the coastal town of St Ives in Cornwall. The surgery is on an upper floor of an end terrace property in St Ives with access via steps and there are also

some steps within the building. There are two treatment rooms and a reception and waiting area.

The practice provides NHS dental services to approximately 4,300 adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers and crowns and bridges.

The surgery is run as an expense sharing partnership between two dentists who are registered as independent providers. The providers share policies, procedures and the majority of support staff. The staff structure of the practice consists of a principal dentist, a practice manager/dental nurse.

The practice opening hours are Monday from 9am to 12.30pm and 2pm to 5.30pm, Monday to Friday. Outside of these hours a service is available via the 111 out of hour’s service. These details are displayed at the entrance to the practice, and are visible from the outside the practice when the practice is closed.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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 with telephone access to a dental specialist advisor.

We spoke with three patients who provided feedback about the service. 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.

Our key findings were:

Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

There were effective systems in place to reduce and minimise the risk and spread of infection.
The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
Staff knew how to report incidents and how to record details of these so that the practice could use this information for shared learning.
Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
The practice had implemented clear procedures for managing comments, concerns or complaints.

Governance arrangements were in place for the smooth running of the practice.

Ms Monika Zbos provides NHS dental treatment at Tregenna Hill Dental Surgery to approximately 4,400 people in west Cornwall. The surgery is run as an expense sharing partnership between two dentists who are registered as independent providers. The providers share policies, procedures and the majority of support staff. In this report, we have used the word ‘surgery’ when referring to the whole service, and ‘practice’ when referring to the individual provider.

The surgery is on an upper floor of an end terrace property in St Ives with access via steps and there are also some steps within the building. There is no wheelchair access.

Seven patients completed our comment cards. They were all favourable, praising the skill of the dentist and the friendliness of the staff. Patients said they had been happy with their care and treatment and they had been treated with dignity and respect. Some said the practice manager had been very helpful. Others said they had been listened to, given advice and their own requests had been discussed so they could agree the right course of treatment with the dentist. The dentist had been working to improve her standards of dental care. She referred patients to other services appropriately when assessing treatment to be beyond her competence.

Safe systems were in place for dealing with medical emergencies and fire safety.

We saw that improvements had been made to the arrangements for infection control in the treatment room since our visit in 2013. The process for decontaminating instruments was in accordance with the essential standards and the dental chair was in good condition.

However, there were also areas of practice where the provider must make improvements;

An audit of the process for decontaminating instruments must be carried out every six months. The tests on machines were not all carried out at the recommended intervals.

There were areas of practice where the provider should make improvements;

Training or guidance should be provided for staff about the Mental Capacity Act 2005 so they know how to obtain professional support where necessary for a patient who could not give informed consent to treatment and whose carer may not make decisions in their best interest.
An assessment should be carried out in accordance with the Disability Discrimination Act. This would identify action that could be taken to help patients with varying disabilities, even with the constraints posed by a historic building.
The provider should carry out a patient survey and record minor concerns so the practice may respond and demonstrate any action taken in response.
The provider should obtain documents when recruiting to demonstrate that anyone working or carrying on a regulated activity is safe and suitable for their position.

We will ask the provider to send us an action plan showing how and when the practice will be compliant with the regulations.

All three of the patients we spoke with were satisfied with the care and treatment they received at Tregenna Hill Dental Surgery. Comments included, 'It's very good', 'they do a very good job', 'if I am feeling anxious the dentist reassures me' and "I have no complaints really'.

People's privacy, dignity and independence were respected and care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were not protected from the risk of infection because appropriate guidance had not been followed. The provider had failed to comply with the Essential Quality Requirements with in HTM01-05 and the dental chair was damaged and difficult to clean effectively.

People were cared for by staff who had not been supported to deliver care and treatment safely and to an appropriate standard.

Archived: Tregenna Hill Dental Surgery

All Inspections

6 April 2016

During a routine inspection

9 December 2014

During a routine inspection

19 November 2013

During a routine inspection