Bloxwich Dental Centre

Updated 26 January 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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This inspection took place on 13 December 2016 and was led by a CQC inspector and supported by a specialist dental advisor. Prior to the inspection, we reviewed information we held about the provider. We informed NHS England area team that we were inspecting the practice and we did not receive any information of concern from them. We asked the practice to send us some information that we reviewed. This included the complaints they had received in the last 12 months, their latest statement of purpose, and the details of their staff members including proof of registration with their professional bodies.

During our inspection we toured the premises; we reviewed policy documents and staff records and spoke with five members of staff. We looked at the storage arrangements for emergency medicines and equipment. We were shown the decontamination procedures for dental instruments and the computer system that supported the dental care records.

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 26 January 2017

We carried out an announced comprehensive inspection on 13 December 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

Bloxwich Dental Centre has four dentists; two who work full time and two who work part time (this includes the two owners of the practice), five qualified dental nurses who are registered with the General Dental Council (GDC), two trainee dental nurses, a practice manager and a receptionist. The practice’s opening hours are 9am to 5pm on Monday to Thursday and 8.30am to 1pm on Friday. The practice closes for lunch each day between the hours of 1pm to 2pm.

Bloxwich Dental Centre provides mainly NHS dental treatments to patients of all ages but also offers private treatment options. The practice has one dental treatment room on the ground floor and two on the first floor. Cleaning, sterilisation and packing of dental instruments takes place in a separate decontamination room. There is a reception with adjoining waiting area and a separate waiting area on the first floor.

Before the inspection we sent Care Quality Commission comments cards to the practice for patients to complete to tell us about their experience of the practice. We received comments from 51 patients by way of these comment cards and during the inspection we spoke with one patient.

Our key findings were

• Systems were in place for the recording and learning from significant events and accidents.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Patients were treated with dignity and respect.
• The practice was visibly clean and well maintained.
• Infection control procedures were in place with infection prevention and control audits being undertaken recently. Staff had access to personal protective equipment such as gloves and aprons.
• There was appropriate equipment for staff to undertake their duties, however records were not available to demonstrate that all fire safety equipment was serviced or maintained. The practice manager notifified us the day following this inspection that an external professional has been booked to complete this on 22 December 2016.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Staff had been trained to deal with medical emergencies and the provider had emergency equipment in line with the Resuscitation Council (UK) guidelines. However not all medicines were available in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice. The practice manager confirmed that the missing medicine would be ordered as a matter of priority and confirmation was received that this had been ordered.
• There was no signage in place identifying that X-ray machinery was located in the room and critical examination packs for each of the X-ray sets were not available for review. X-ray signage was put in place the day following out inspection.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The governance systems were effective.
• The practice was well-led and there were clearly defined leadership roles within the practice. Staff told us they felt supported, involved and they all worked as a team.

There were areas where the provider could make improvements and should

• Review the practice’s systems to ensure that they are is in compliance with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review the practice’s consent policies and procedures giving due regard to the Mental Capacity Act 2005 (MCA) and ensure staff obtain a good understanding of processes involved in consent.