Archived: S Owen & Associates

Updated 6 April 2017

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

The inspection was carried out on 15 March 2017 by a CQC inspector and a dental specialist adviser. We reviewed information we held about the provider and information that we asked them to send us in advance of the inspection.

During the inspection we spoke with dentists, dental nurses, the practice manager and reception staff. We looked around the premises including the treatment rooms. We looked at policies and procedures and other documents and read the comments made by 21 patients in CQC comment cards. The practice provided their 2016 NHS Friends and Family Test results.

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 6 April 2017

We carried out an announced comprehensive inspection on 15 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

S Owen & Associates dental practice is in the Herefordshire market town of Leominster, close to the town centre. It provides 98% NHS dental treatment for all age groups and a very small amount of private dental treatment. The practice has been established in Leominster for over 20 years moving to new purpose built premises in 2006. The premises are owned by the NHS and managed by NHS Property Services which charges the practice for maintenance arrangements. There is an NHS Dental Access Centre in the same building.

In January 2016 the Department of Health (DH) announced the launch of a prototype process as the next stage in the reform of NHS dentistry. S Owen and Associates is one of 82 practices in England selected to take part in the Dental Prototype Agreement Scheme. They are testing new ways of providing NHS dental care with an increased emphasis on preventing future dental disease.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual and is therefore a ‘registered person’. 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 practice has six dentists (including the principal dentist), a senior dental nurse, three dental nurses and two trainee dental nurses. The clinical team are supported by a practice manager and two reception staff.

The practice has four dental treatment rooms and a separate decontamination room for the cleaning, sterilising and packing of dental instruments. The chairs in the spacious waiting room are away from the reception area which helps provide privacy when staff are dealing with patients. The design of the building provides full access for patients with disabilities. The adjacent public car park has designated spaces for patients with disabilities.

The practice is open from 9am to 5pm Monday to Friday and closes for lunch from 1pm to 2pm.

Before the inspection we sent Care Quality Commission comment cards to the practice so patients could give us their views. We collected 21 completed cards which provided a consistently positive view of the standard or care and treatment provided. Patients spoke highly of the practice team who they described as caring, warm, respectful and thorough. Patients who commented about this confirmed that their dentist listened to them and explained their treatment clearly. Patient feedback was positive about standards of cleanliness. The results of the practice’s 76 NHS Friends and Family Test forms completed during the previous six months were positive and showed that 91% of the patients who took part were extremely likely and 8% were likely to recommend the practice.

Our key findings were:

• The practice was visibly clean and feedback from patients confirmed this was their experience. National guidance for cleaning, sterilising and storing dental instruments was followed. The cleaning company responsible for cleaning the floors and non-clinical areas was not carrying out all of its duties satisfactorily.
• The practice had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.
• The practice had arrangements for dealing with medical emergencies.

• Dental care records provided clear information about patients’ care and treatment and patients received written treatment plans where necessary.
• Staff received training appropriate to their roles and were supported to meet the General Dental Council’s continuous professional development requirements.

• Patients were able to make routine and emergency appointments when needed and gave us positive feedback about the service they received.

• The practice used the NHS Friends and Family Test, to enable patients to give their views about the practice. Staff had opportunities to contribute their views through daily discussions, staff meetings and annual appraisals.

• The practice had policies and procedures and other documentation to help them manage the service.

• The practice used audit as a means to monitor quality in a range of areas and used repeat audits to support continuous improvement.

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

• Review information kept at the practice in respect of the products used with reference to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 to assure themselves that all documentation is up to date.

• Review arrangements for monitoring those services not directly managed by the practice to assure themselves that these are being carried out satisfactorily.

• Review the business continuity plan to include a broader range of events which would disrupt the service.