31 October 2016
During a routine inspection
We carried out an announced comprehensive inspection on 31 October 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 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
Cambourne Dental Practice is situated nine miles from the city of Cambridgeshire. The service provides a range of dental NHS services to patients of all ages with some private treatments also available. The practice has its own small car park and is situated close to public car parks. The practice has four dental treatment rooms, a decontamination room, a large ground floor reception/waiting area and a small first floor waiting area.
The practice opens weekdays from 8am and has extended opening until 7.30pmon Monday and Tuesdays. The practice closes at 5pm Wednesday and Thursdays, and midday on Fridays. The service is run by Southern Dental Limited who provide care at approximately 80 NHS and private dental practices. They employ three dentists and four hygienists. They are supported by a practice manager, three dental nurses (two of whom are trainee dental nurses), a receptionist and a cleaner.
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 18 patients either in person or on CQC comments cards from patients who had visited the practice in the two weeks before our inspection. The cards were all positive and commented about the level of care and treatment they had received and the helpful and reassuring manner of the staff.
Our key findings were:
- There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
- Staff had received training in handling medical emergencies and had access to appropriate medicines and life-saving equipment in accordance with current guidelines.
- The practice appeared very clean and well maintained.
- Infection control procedures were in place and the practice followed published guidance. However the use of the ultrasonic washer required a review to ensure appropriate and safe use during busy periods.
- An accident and incident reporting system was in place although few had been reported. The policy required strengthening so that staff could differentiate between significant events, incidents and near miss events and use opportunities to maximise learning.
- Patients told us they received good dental care and were usually able to book convenient appointments. They told us staff were kind and helpful.
- Governance arrangements were in place for the smooth running of the practice although these systems could be further strengthened through improved communication with the corporate management team.
- Information from 15 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.
There were areas where the provider could make improvements and should:
- Review the system for recording details of accidents so that progress and actions can be tracked. Review the identification process for significant events, near miss incidents and accidents so that staff recognise and act on these occurrences to promote learning and improvement.
- Review the way the fridge temperatures are monitored and recorded to ensure that dental care products are stored in line with the manufacturer’s guidance.
- 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 staff awareness of Gillick competency, the requirements of the Mental Capacity Act (MCA) 2005 and medical emergencies scenario training so that staff are aware of their responsibilities.
- Review the accessibility of the complaints process and access to health information leaflets for patients. Ensure that the process followed by staff when using the ultrasonic washer minimises the risk that dental instruments may not be cleaned effectively and ensure that the preparation of matrix bands promotes safe use for patients.
- Review the recruitment policy and procedures in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.