20 December 2018
During an inspection looking at part of the service
We carried out this announced inspection on 20 December 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in 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
My Dentist Upper Northgate Street is in Chester town centre and provides NHS and private treatment to adults and children.
There is level access for people who use wheelchairs and those with pushchairs; the practice is fitted with a lift which can take wheelchair users and those with prams to the first floor, where the treatment rooms are fully accessible. There is no car parking immediately outside the practice but a public car park is available near the practice.
The dental team includes five dentists, one visiting dental implantologist, seven dental nurses, two of these being trainees, one dental hygienist, one dental hygiene therapist. The practice is managed on a daily basis by the practice manager who is also the Registered Manager. The clinical team are supported by a treatment co-ordinator and three receptionists. The practice has five treatment rooms.
The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at My Dentist Upper Northgate Street is the practice manager.
On the day of inspection, we collected 17 CQC comment cards filled in by patients.
During the inspection we spoke with two dentists, one dental nurse, the dental hygiene therapist, one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open: Tuesday, Thursday and Friday from 9am to 5.30pm, and on Monday from 9am to 7pm. On Wednesday the practice opens from 9am to 6.30pm.
Our key findings were:
- The practice appeared clean and well maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to help them manage risk to patients and staff.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider 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.
- Staff were providing preventive care and supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and culture of continuous improvement.
- Staff felt involved and supported and worked well as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- The provider had suitable information governance arrangements.
There were areas where the provider could make improvements. They should:
- Review the practice's complaint handling procedures and establish an accessible system for identifying, receiving, recording, handling and responding to complaints by service users.
- Review the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. For example, to identify a lead Radiation Protection Supervisor.
- Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice. For example, the process for handling medical history updates to be sure these are scanned to electronic patient dental care records.
- Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice. For example, that checks performed by locum agencies are confirmed.
- Review the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. For example, by completing works required to address water flow issues on the lower ground floor, that have given rise to a malodourous smell.