Archived: Pomfret Duncan & Singh

Updated 29 July 2016

This announced inspection was carried out on 22 March 2016 by an inspector from the Care Quality Commission (CQC) and a specialist dental advisor.

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.

Prior to the inspection we reviewed information we held about the provider. This included information from NHS England and notifications which we had received.

During the inspection we viewed the premises, spoke with dentists, dental nurses, receptionists and the practice manager. To assess the quality of care provided we looked at practice policies and protocols and other records relating to the management of the service.

We also reviewed information we asked the provider to send us in advance of the inspection. This included their latest statement of purpose describing their values and objectives and a record of any complaints received in the last 12 months.

We obtained the views of 41 patients who had completed CQC comment cards and we spoke with three patients who used the service on the day of our inspection.

Updated 29 July 2016

We carried out an announced comprehensive inspection on 22 March 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

Pomfret Duncan & Singh provides mostly NHS dental treatment to adults and children. It also provides a number of additional private treatments such as cosmetic crowns and tooth whitening.

The practice has four dentists working a variety of clinical sessions over a week. The dentists are supported by dental hygienists and dental nurses. A practice manager and receptionists completed the team. The practice opens from Monday to Thursday between 8am and 5pm. Appointments are available between 8.30am and 12.30pm; and between 2pm and 5pm each day.

Emergency appointments are available each day.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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.

We received feedback from 41 patients via CQC comment cards, this feedback was very positive about the care and treatment received from all staff within the practice.

Our key findings were:

• The practice recorded and analysed significant events and cascaded learning to staff.
• Complaints and concerns were handled informally and were not used as an opportunity to learn.
• There were effective systems in place to reduce the risk and spread of infection.
• There were limited systems in place to check all equipment had been serviced regularly.
• Staff had received some basic safeguarding training and knew the procedures to follow to raise any concerns. This training was not to the standard expected of dental professionals.
• Patient’s care and treatment was planned and delivered in line with evidence based guidelines; however not all new guidance was being implemented.
• The practice ensured staff maintained the necessary skills and competence to support their professional registration, but other training for example the Mental Capacity Act had not been made available. Staff had not received an annual appraisal.
• The recruitment policy was not always being followed. Appropriate checks were not carried out when new staff were employed.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available. However records were not maintained in respect of the checks carried out for this equipment to ensure that it was working properly.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity, respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• Governance systems required updating to ensure that appropriate monitoring of the services provided were carried out to improve quality and safety.
• The practice did not have a programme of continuous clinical and internal audit in order to monitor quality and make improvements.
• The practice sought feedback from staff and patients about the services they provided. 

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

• Ensure patients' safety is protected by using rectangular collimation during radiation.
• Review the arrangements for staff training so that it includes role specific safeguarding children training, Mental Capacity Act 2005 and Gillick awareness training; and that staff appraisal is recorded.
• Review the staff files so that they include documentation in respect of the recruitment checks carried out.
• Make information in respect of complaints accessible to patients.
• Review the systems for monitoring the quality and safety of the services provided so that these include monitoring and auditing radiography, monitoring and checking equipment, learning from complaints and reviewing current guidance and imbedding this into practice.