Archived: The Nightingale Clinic

Updated 14 July 2016

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.

The inspection took place on the 24 June 2016 and was undertaken by a CQC inspector and a dental specialist advisor. Prior to the inspection we reviewed information submitted by the provider.

The methods used to carry out this inspection included speaking with principal dentists, two dental nurses and one receptionist on the day of the inspection, reviewing documents, completed patient feedback forms and observations.

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 14 July 2016

We carried out an announced comprehensive inspection on 24 June 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

The Nightingale Clinic located in Newham provides a mix of NHS and private dental treatment including conscious sedation, minor oral surgery, orthodontic, some general dentistry and the placement of dental implants. The practice also provides under contract with NHS England conscious sedation and minor oral surgery services. [ Conscious sedation – procedure using a combination of medicines to help a patient to relax (a sedative) and to block pain (an anaesthetic) during a medical or dental procedure. The patient remains awake during the whole procedure.}

Practice staffing consists of two principal dentists, four associate dentists, two orthodontic specialists, three oral surgeons, two qualified anaesthetist, recovery practitioner, nine dental nurses, five receptionists and a practice manager.

The practice manager 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.

The practice is open Monday to Friday 8.00am to 5.30pm

The practice facilities include eight treatment rooms a well-equipped sedation suite where conscious sedation is provided by a qualified medical anaesthetist, reception and waiting area, consultation room, decontamination room, one office and a staff room/kitchen.

42 patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received about the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• There were systems in place to ensure that all equipment was maintained in line with manufacturer’s guidelines.
• The practice ensured staff were trained and that they maintained the necessary skills and competence to support the needs of patients.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Conscious sedation was delivered safely in accordance with current guidelines.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice.
• The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.