• Dentist
  • Dentist

Prescot House Dental Surgery

3 High Street, Prescot, Merseyside, L34 3LD (0151) 426 6460

Provided and run by:
Prescot House Dental Surgery Partnership

Important: The partners registered to provide this service have changed. See old profile

All Inspections

19 December 2019

During an inspection looking at part of the service

We undertook a follow-up focused inspection of Prescot House Dental Surgery on 19 December 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Prescot House Dental Surgery on 2 July 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe or well-led care and was in breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Prescot House Dental Surgery on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it safe?

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 2 July 2019.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 2 July 2019.

Background

Prescot House Dental Surgery is in Prescot, Merseyside and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including for blue badge holders, are available near the practice at a pay and display car park.

The dental team includes six dentists, eight dental nurses, one of whom is a trainee, and one dental hygiene therapist, and a practice manager.

The practice is owned by a partnership 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 Prescot House Dental Practice is the practice manager.

During the inspection we spoke with two dentists, one dental nurse and the practice manager. We looked at practice policies and procedures and other records about how the service is managed. We also reviewed actions taken by the provider, to address the regulatory breaches highlighted at our last inspection.

The practice is open: Monday to Friday, 9am to 1pm and from 2pm to 5.30pm. The practice provides extended opening hours on Wednesdays, when the practice is open until 8pm, and on Saturday morning from 9am to 1pm.

Our key findings were:

  • Medicines and equipment for use in a medical emergency were available as described in recognised guidance. This included medical oxygen available in sufficient quantity and portable suction.
  • All medicines were in date and ready for use. All medicines were stored correctly, in line with manufacturer guidance.
  • All required recruitment checks were in place for all staff.
  • The Hepatitis B immunity status was confirmed for all staff. Those staff who required a booster immunisation had received this. For any staff who had shown an immune response below that expected, there was a risk assessment in place which was focussed on minimizing the risk of injury from contaminated instruments and materials.
  • Staff were using appropriate personal protective equipment (PPE) when carrying out decontamination duties and when working in treatment rooms.
  • Oversight of staff training had improved. We saw that training in infection control, safeguarding and basic life support was in place for all staff, and to the appropriate level.
  • Effective recruitment processes were in place and were followed for recruitment of staff new to the practice.
  • Effective checks on emergency equipment and medicines were in place; all items as required by recognised guidance were present and ready for use.
  • Radiography audits were in place which covered the work of all dentists at the practice.
  • Infection control audits were in place and were scheduled to take place at the correct intervals (six monthly).
  • A system was in place for receiving and sharing medical alerts, updates and bulletins from relevant agencies, for example, the Medicines and Healthcare Regulatory Agency (MHRA) and the National Institute of Health and Care Excellence (NICE).

The provider had also made further improvements.

  • A system of antibiotic audit was in place and was being followed by all dentists at the practice.
  • A calendar of audit was in place to drive continuous improvement. This included radiograph audit, patient record audit and infection control audit.
  • A disability access audit was now in place. A hearing loop was now available in the practice for those patients that required this. This device was also portable so could be used in the treatment rooms.

2 July 2019

During a routine inspection

We carried out this announced inspection on 2 July 2019 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 not 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

Prescot House Dental Surgery is in Prescot, Merseyside and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including for blue badge holders, are available near the practice at a pay and display car park.

The dental team includes six dentists, eight dental nurses, one of whom is a trainee, and one dental hygiene therapist, and a practice manager.

The practice is owned by a partnership 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 Prescot House Dental Practice is the practice manager.

On the day of inspection, we collected 42 CQC comment cards filled in by patients. All feedback was highly positive about treatment and staff at the practice.

During the inspection we spoke with three dentists, 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 to Friday, 9am to 1pm and from 2pm to 5.30pm. The practice provides extended opening hours on Wednesdays, when the practice is open until 8pm, and on Saturday morning from 9am to 1pm.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The provider had infection control procedures which reflected published guidance. Some of these were not universally observed by all staff.
  • Staff knew how to deal with emergencies.
  • Appropriate medicines and life-saving equipment were not available, as described in recognised guidance.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had staff recruitment procedures in place, but records to support this were not maintained.
  • There was no effective system in place to receive, record and share safety alerts and clinical updates with all staff.
  • 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 provided preventive care and supported patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • The leadership of the practice required improvement.
  • Continuous improvement initiatives were in place, but not spread evenly across the practice, for example, audits of work did not cover all dentists.
  • The provider asked patients for feedback about the services they provided. This evidence was not collated and shared with staff.
  • The provider dealt with complaints positively and efficiently.
  • The governance arrangements in place required improvement.

We identified regulations the provider was not complying with. They must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure care and treatment is provided in a safe way to patients.

Full details of the regulations the provider is not meeting are at the end of this report.

There were areas where the provider could make improvements. They should:

  • Introduce protocols regarding the prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.

12/12/2017

During an inspection looking at part of the service

We carried out a follow up inspection on 12 December 2017 at Prescot House Dental Surgery.

On 22 March 2017 we undertook an announced comprehensive inspection of this service as part of our regulatory functions. During this inspection we found a breach of the legal requirements.

A copy of the report from our comprehensive inspection can be found by selecting the 'all reports' link for Prescot House Dental Surgery on our website at www.cqc.org.uk.

After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breach.

We revisited Prescot House Dental Surgery on 18 October 2017 to confirm whether they had followed their action plan, and to check whether they met the legal requirements in the Health and Social Care Act 2008 and associated regulations. During this inspection we found breaches of the legal requirements.

A copy of the report from our follow-up inspection can be found by selecting the 'all reports' link for Prescot House Dental Surgery on our website at www.cqc.org.uk.

After the follow-up inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breaches.

We revisited Prescot House Dental Surgery on 12 December 2017 to confirm whether they had followed their action plan, and to check whether they met the legal requirements in the Health and Social Care Act 2008 and associated regulations. This report only covers our findings in relation to those requirements.

We carried out the announced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

We reviewed the practice against oneof the five questions we ask about services: is the service well-led?

The inspection was led by a CQC inspector who had remote access to a specialist dental adviser.

Our findings were:

Are services well-led ?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Prescot House Dental Surgery is close to the centre of Prescot and provides dental care and treatment to adults and children on an NHS or privately funded basis.

There are steps at the front entrance to the practice with a handrail positioned alongside to assist patients with limited mobility. The provider has installed a ramp to facilitate access to the practice for wheelchair users. The practice has five treatment rooms. Car parking is available near the practice.

The dental team includes a principal dentist, four associate dentists, a dental hygienist and eight dental nurses, some of whom also carry out reception duties. The team is supported by a practice manager.

The practice is owned by a partnership and as a condition of registration must have in place a person registered with the Care Quality Commission as the registered manager. Registered managers have a 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 Prescot House Dental Surgery is the practice manager.

The practice is open:

Monday, Tuesday, Thursday and Friday 9.00am to 5.30pm

Wednesday 9.00am to 8.00pm

Occasional Saturdays 9.00am to 1.00pm

Our key findings were:

  • The practice had improved their systems in relation to recruitment, medical emergencies, stock control of dental materials, and training. We found these were operating effectively.
  • We found risks were appropriately managed specifically in relation to the Hepatitis B immunisation status of the clinical staff.
  • The practice had improved their arrangements for communicating feedback to staff and patients.

18/10/2017

During an inspection looking at part of the service

We carried out a follow up inspection on 18 October 2017 at Prescot House Dental Surgery.

On 22 March 2017 we undertook an announced comprehensive inspection of this service as part of our regulatory functions. During this inspection we found a breach of the legal requirements.

A copy of the report from our comprehensive inspection can be found by selecting the 'all reports' link for Prescot House Dental Surgery on our website at www.cqc.org.uk.

After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breach. This report only covers our findings in relation to those requirements.

We revisited Prescot House Dental Surgery on 18 October 2017 to confirm whether they had followed their action plan, and to confirm that they now met the legal requirements in the Health and Social Care Act 2008 and associated regulations. We carried out this unannounced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

We reviewed the practice against oneof the five questions we ask about services: is the service well-led?

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

Our findings were:

Are services well-led ?

We found that this practice was not providing well-led care in accordance with the relevant regulations.

Background

Prescot House Dental Surgery is close to the centre of Prescot and provides dental care and treatment to adults and children on an NHS or privately funded basis.

There are steps at the front entrance to the practice with a handrail positioned alongside to assist patients with limited mobility. The provider has installed a ramp to facilitate access to the practice for wheelchair users. The practice has five treatment rooms. Car parking is available near the practice.

The dental team includes a principal dentist, four associate dentists, a dental hygienist and eight dental nurses, some of whom also carry out reception duties. The team is supported by a practice manager.

The practice is owned by a partnership and as a condition of registration must have in place a person registered with the Care Quality Commission as the registered manager. Registered managers have a 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 Prescot House Dental Surgery is the practice manager.

The practice is open:

Monday, Tuesday, Thursday and Friday 9.00am to 5.30pm

Wednesday 9.00am to 8.00pm

Occasional Saturdays 9.00am to 1.00pm

Our key findings were:

  • The practice had improved their infection control procedures.
  • We found that the practice had reviewed their safeguarding and whistleblowing processes and made them specific to the practice.
  • The practice had improved their procedure for dealing with complaints.
  • The practice had systems in place in relation to recruitment, medical emergencies, stock control of dental materials, and training. We found these were not operating effectively and had not been improved since our initial inspection.
  • We found not all risks were appropriately managed particularly in relation to the Hepatitis B immunisation status of the clinical staff.

We identified regulations the provider was not meeting. They must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure recruitment procedures are operated effectively to ensure only fit and proper persons are employed.

Full details of the regulations the provider was not meeting are at the end of this report.

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

  • Review the practice’s protocols in relation to the use of closed circuit television to ensure staff and patients are fully informed as to its purpose and their right to access footage.
  • Review the practice’s audit protocols of various aspects of the service such as radiography to help improve the quality of service. The practice should also ensure all audits have documented learning points, where relevant, and the resulting improvements can be demonstrated.

22 March 2017

During a routine inspection

We carried out an announced comprehensive inspection on 22 March 2017 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

Prescot House Dental Surgery is located near the centre of Prescot. The practice comprises a reception and waiting room, five treatment rooms, an X-ray room, a decontamination room and patient toilet facilities. The practice also has a dental laboratory facility on the premises. Parking is available near the practice. The practice is accessible to patients with disabilities, limited mobility, and to wheelchair users.

An external ramp facilitates access to the premises for wheelchair users and people with pushchairs. Closed circuit television monitoring is in place at the premises externally and internally in the reception, waiting room, records room and one of the staff rooms.

The practice provides general dental treatment to patients on an NHS or privately funded basis. The opening times are Monday, Tuesday, Thursday and Friday 9.00am to 5.30pm, Wednesday 9.00am to 8.00pm and Saturday 9.00am to 1.00pm. The practice is staffed by a principal dentist, a practice manager, three associate dentists and eight dental nurses who also carry out reception duties.

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.

We received feedback from 29 people during the inspection about the services provided. Patients commented that they found the practice excellent, and that staff were professional, friendly, and caring. They said the dentists carefully listened to them and they were always given good and helpful explanations about dental treatment. Patients commented that the practice was clean and comfortable and they were always accommodated in an emergency.

Our key findings were:

  • The practice had procedures in place to record, analyse and learn from significant events and incidents.
  • There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
  • The premises were clean, secure and well maintained.
  • Patients’ needs were assessed, and care and treatment were delivered, in accordance with current standards and guidance.
  • Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
  • Staff were supported to deliver effective care, and opportunities for training and learning were available.
  • Patients were treated with kindness and respect, and their confidentiality was maintained.
  • Appointments were available at a variety of times of the day.
  • The practice gathered and took account of the views of patients.
  • Staff were supervised and worked together as a team.
  • Governance arrangements were in place for the running of the practice. Not all of these were operating effectively.
  • Staff had received safeguarding training, and knew the processes to follow to raise concerns, but there was no practice specific policy to guide them.
  • Staff had been trained to deal with medical emergencies. Not all recommended emergency medicines and equipment were available.
  • Infection control arrangements were in place but improvements were needed to these.

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

  • Ensure the practice’s infection control procedures and protocols are suitable having 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 that systems and processes are established and operated effectively, to safeguard patients from abuse, and to allow staff to raise concerns.
  • Ensure the systems and processes for managing medical emergencies are operated effectively having due regard to guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council standards for the dental team.
  • Ensure the practice's recruitment procedures are suitable and the recruitment arrangements are in accordance with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure the necessary employment checks are identified for all staff and the required specified information in respect of persons employed by the practice is available.
  • Ensure an effective system is established to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities, including those in relation to sharps and staff immunisation.

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 stocks of medicines and equipment and the system for identifying and disposing of out-of-date stock.
  • Review the practice’s waste handling procedures to ensure waste is disposed of in accordance with the relevant regulations having due regard to guidance issued in the Health Technical Memorandum 07-01.
  • Review staff awareness of the requirements of the Mental Capacity Act 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
  • Review the complaints procedure to ensure details of alternative organisations to which patients can complain are readily available.
  • Review the practice’s protocols in relation to the use of closed circuit television to ensure staff and patients are fully informed as to its purpose and their right to access footage.
  • Review the practice’s audit protocols to ensure audits, such as radiography and infection control, are undertaken at regular intervals to help improve the quality of service. The practice should also ensure all audits have documented learning points which are shared with staff and the resulting improvements can be demonstrated.

13 November 2013

During a routine inspection

We spoke with three people who used the service. They were very satisfied with the treatment they had received. They told us they were given options about their treatment when they visited the dentist and that the dentists explained different treatment options that were available and what the treatment entailed.

People told us the service had been professional, reliable and friendly and that they felt the dentists and dental nurses were skilled. We observed good rapport between the people who used the service and staff.

People told us they had signed documentation to give their consent to treatment and that staff checked peoples' medical histories and medication. People told us they found the surgery to be clean and hygienic and that staff had high standards of cleanliness and infection control. When we looked around the practice we saw evidence that the premises were kept clean. We also saw evidence of effective infection control systems in place.

We also saw evidence that the dentists and dental nurses had been professionally trained to the level their positions required. We also saw that they had completed training in other appropriate courses. We saw evidence that there was a quality assurance system in place that informed the future performance of the service.