Mydentist - Sneinton Dale - Nottingham

We carried out an announced comprehensive inspection on 21 October 2015 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 not providing well-led care in accordance with the relevant regulations

Background

We carried out a comprehensive inspection of Lyndhurst Family Dental Practice on 4 November 2015. The practice is a member of mydentist group and provides both NHS and private dental treatment to patients of all ages. The practice has six self-employed dentists, one dental therapist, and employs nine dental nurses, one trainee dental nurse, 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 operates over 2 floors in a four storey building converted from two houses. Access to the main reception area, one consultation room and patient toilet (suitable for disabled people) is on ground level, with three treatments rooms and waiting area accessible by a few steps. Additional surgeries, waiting area and patient toilet, not accessible to patients who cannot negotiate stairs, are located on the upper first floor and second floor. There is on street parking available around the building.

The practice is open Monday to Friday from 9.00am to 5.30pm, late opening for both NHS and private patients is offered, the times vary and displayed in the waiting areas. Domiciliary dentistry is offered to patients living in local care homes.

We spoke with four patients during our inspection and received four comments cards that had been completed by patients prior to our inspection. We received positive comments about the cleanliness of the premises, the empathy, and responsiveness of staff and the quality of treatment provided. Patients commented that the building is in need of refurbishment.

The patients we spoke with told us that staff explained treatment to them well and reported that the practice had seen them on the same day for emergency treatment. Patients commented that the service they received was good, and that they were always clear about the costs involved in their treatment.

Our key findings were:

• Poor maintenance of the building fabric, fixtures, and fittings had potentially compromised the practice’s ability to comply with infection prevention standards.

• The practice had systems to help ensure patient safety. These included safeguarding children and adults from abuse, and assessing risks to staff and patients.

• Staff received training appropriate to their roles and supported in their continued professional development.

• There were sufficient numbers of staff to meet patients’ needs.

• Patients’ needs were assessed and care was planned in line with guidance from the National Institute for Health and Care Excellence (NICE).

• The practice sought feedback from staff and patients and used it to improve the service provided.

• There was a lack of clinical leadership and systems evident in the practice to ensure quality assurance of standards and processes.

• The assurance process for monitoring the quality of X-ray images was irregular and insufficient to reduce the risk of patients being subjected to further unnecessary X-rays.

We identified regulations that were not being met and the provider must:

• Ensure that the fabric of the building, fixtures, and fittings are maintained to comply with infection prevention standards.
• Strengthen quality assurances processes to ensure that standards are met to keep patients and staff safe.
• Ensure that all clinical waste is labelled and collected regularly.
• Ensure that regular quality checks of X-ray images are undertaken, recorded, where quality is poor, it is investigated, and changes made to ensure that patients are kept safe.
• Ensure accurate record keeping for changing of chemicals used in the X-ray developing machine.

You can see full details of the regulations not being met at the end of this report.

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

• Improve the system to ensure that learning from individuals, their audits, and reviews is recorded, shared, and available with the wider practice team.
• Strengthen the clinical leadership within the practice.