21 September 2017
During a routine inspection
We carried out this announced inspection on 21 September 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We carried out the inspection to follow up concerns we originally identified during a comprehensive inspection at this practice on 11/12 November 2015 under the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
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 form the framework for the areas we look at during the inspection.
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
Clent Dental Care is located in a residential area in Hagley and provides private treatment to patients of all ages.
There is level access for people who use wheelchairs and pushchairs. The practice is in a renovated residential bungalow with all rooms on one level consisting of a reception area with a waiting room, two patient toilets one of which is wheelchair accessible, two dental treatment rooms, a staff room / kitchen, a practice management office and a decontamination room for the cleaning, sterilising and packing of dental instruments. There is also a beautician’s room which is currently not in use and was not reviewed as part of this inspection. Car parking spaces, including spaces for patients who are blue badge holders, are available directly outside the practice in their dedicated car park.
The dental team includes the principal dentist, two dental nurses, one dental hygienist, one receptionist and the practice manager. The practice has two treatment rooms.
The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
On the day of inspection we collected 29 CQC comment cards filled in by patients. This information gave us a positive view of the practice.
During the inspection we spoke with the principal dentist, two dental nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday: 9am – 7pm
Tuesday: by appointment only
Wednesday: 9am to 7pm
Thursday: 9am to 5pm
Friday: by appointment only
Our key findings were:
- The practice was mostly clean and well maintained; there was scope to improve the environmental cleaning of high areas in the dental treatment rooms and to replace a dental unit with a broken frame which impeded the unit being able to be cleaned thoroughly.
- The practice had infection control procedures and a policy however these were not always fully adhered to by all staff members.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available with the exception of one medicine that had been incorrectly disposed of; this was re-ordered on the day of our inspection.
- The practice had systems to help them manage risk.
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
- The practice had thorough staff recruitment procedures.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- The appointment system met patients’ needs.
- The practice had effective leadership. Staff felt involved and supported and worked well as a team.
- The practice asked staff and patients for feedback about the services they provided.
- The practice dealt with complaints positively and efficiently.
There were areas where the provider could make improvements. They should:
- Review the practice’s systems in place for environmental cleaning taking into account current national guidelines.
- Review the practice’s infection control procedures and protocols to take into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
- Review the practice’s protocols for the use of rubber dam for root canal treatment.
- Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.