Approach Dentistry

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We found this practice was not providing well-led care in accordance with the relevant regulations. We will be following up on our concerns to ensure they have been put right by the provider. During our assessment of this key question, we found The registered person had systems or processes that operated ineffectively in that they failed to enable the registered person to assess, monitor and improve the quality and safety of the services being provided. The practice did not have effective processes in place to monitor staff training to ensure appropriate action can be taken quickly when training requirements are not met. We also found concerns around the effectiveness of the systems or processes to assess, monitor and mitigate the risks relating to recruitment of staff, and other risks related to the carrying on the regulated activities, such as fire safety, Legionella management and premises safety. This resulted in a breach of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Shared direction and culture is based on the latest evidence we assessed for the Well-led key question.

The judgement for Capable, compassionate and inclusive leaders is based on the latest evidence we assessed for the Well-led key question.

The judgement for Freedom to speak up is based on the latest evidence we assessed for the Well-led key question.

The judgement for Workforce equality, diversity and inclusion is based on the latest evidence we assessed for the Well-led key question.

We found staff to be open to discussion and feedback. Where the assessment had identified areas which required improvement, these were acted on immediately. The practice staff demonstrated a transparent and open culture in relation to people’s safety. Staff told us there was strong leadership with emphasis on people’s safety and continually striving to improve. Staff told us they had clear responsibilities, roles and systems of accountability to support good governance and management. Feedback from staff was obtained through meetings and informal discussions. Staff were encouraged to offer suggestions for improvements to the service, and they generally felt they were listened to, where appropriate. One staff member said that ‘leaders welcome feedback and encourage face to face interaction’. However, some staff members commented that although leaders were approachable, they did not feel that they always listened, and problems brought up were not always considered. Staff stated they felt respected, supported and valued. They were proud to work in the practice. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities. A trainee staff member commented on the ongoing support they received during their time at the practice. Staff told us how they collected and responded to feedback from patients, the public and external partners. For example, in a recent patient satisfaction survey conducted by the practice, 14 out of 14 patients said they would recommend this practice to a friend. One patient added that this was a ‘fantastic surgery’ and they have received ‘excellent service since 1970’. The practice had taken steps to improve environmental sustainability. For example, they recycled waste where possible and tried to reduce the use of plastic.

Not all information and evidence required for our assessment was readily available. For example, a number of recruitment and training documents were only provided after the inspection. Improvements were needed to the oversight of the practice to ensure information about systems and processes, including recruitment and training monitoring, were readily available and embedded in the day to day running of the practice. We saw the processes for identifying and managing risks and performance were not always effective. Improvements were required to improve the practice's risk management systems for monitoring and mitigating the risks around safe recruitment of staff, fire safety, Legionella and the safe use of equipment. The practice had engaged an external company to help with their governance system, including policies, protocols and procedures. The compliance manager spent one or two days a month on site. Improvements were needed to the systems in place for ongoing management and oversight to ensure issues were identified promptly to drive continuous improvement and information was shared with staff effectively. Following the inspection the provider told us that a staff member would be upskilled to take on a more extended role in management and moving forward one of the associate dentists would provide ongoing supervision. The practice had systems to review and investigate incidents and accidents, and for receiving and acting on safety alerts. The practice responded to concerns and complaints appropriately. Staff discussed outcomes to share learning and improve the service. The practice had systems and processes for learning, quality assurance and continuous improvement. This included undertaking audits according to recognised guidance.

The judgement for Partnerships and communities is based on the latest evidence we assessed for the Well-led key question.

The judgement for Learning, improvement and innovation is based on the latest evidence we assessed for the Well-led key question.