Archived: S Kirkup Dental Surgeon - Frederick Street South

We carried out an announced comprehensive inspection on 29 September 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 not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was not 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

S Kirkup Dental Surgeon is situated in Meadowfield, Durham. The practice has two treatment rooms, a reception desk contained within one treatment room, a waiting area and an office. Car parking is available on the-streets outside the practice. Access for wheelchair users or pushchairs is possible via the ramp outside and both treatment rooms are located on the ground floor.

The practice is open Monday, Tuesday and Thursday 0900-1700, Wednesday and Friday 0900-1200 and provides predominantly NHS treatment to patients of all ages.

The dental team is comprised of the principal dentist, a dental hygienist who works one day a week and two qualified dental nurses / receptionists.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

We reviewed 33 CQC comment cards on the day of our visit; patients were very positive about the staff and standard of care provided at the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• All staff were welcoming and friendly.
• The practice had systems for recording incidents and accidents.
• Staff received annual medical emergency training.
• Patients were very positive about their experiences at this practice.
• Patients could access urgent care when required.
• The practice did not have sufficient emergency medicines or equipment to manage medical emergencies.
• Staff were not clear on recent dental guidance in infection prevention and control, dental sharps and dental radiography.
• The practice did not have a structured audit cycle in place to monitor the quality and safety of dental treatment and administrative work.
• Staff lacked sufficient support for undertaking their continuous professional development.
• Dental care records were not detailed to provide continuation of care or as per guidance from the Faculty of General Dental Practitioners.

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

• Ensure the availability of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Ensure the practice’s infection control procedures and protocols are suitable giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum

01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.

• Ensure the practice’s sharps handling procedures and protocols are in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Ensure audits of various aspects of the service, such as radiography, infection prevention and control are undertaken at regular intervals to help improve the quality of service. The practice should also ensure all audits have documented learning points and the resulting improvements can be demonstrated.
• Ensure staff are up to date with their mandatory training and their Continuing Professional Development (CPD)
• Ensure that the practice is in compliance with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.
• Ensure that systems and processes are established and operated effectively to safeguard patients from abuse.

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:

• Review the practice’s safeguarding policy and staff training to ensure it covers both children and adults and all staff are trained to an appropriate level for their role and aware of their responsibilities.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).

• Review dental care records are maintained appropriately giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice protocols and adopt an individual risk based approach to patient recalls giving due regard to National Institute for Health and Care Excellence (NICE) guidelines.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.

Review the practice’s protocols and procedures for promoting the maintenance of good oral health giving due regard to guidelines issued by the Department of Health publication ‘delivering better oral health: an evidence-based toolkit for prevention’.