Updated 13 September 2019
We carried out this announced inspection on 30 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 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
Stanley Dental Practice is in Kidderminster 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 are available in the practice car park at the front of the building. There are no bay markings or designated parking spaces for blue badge holders.
The dental team includes five dentists including a foundation dentist, six dental nurses, one dental hygiene therapist, four receptionists three of whom are dental nurse qualified and the practice manager. The practice has six treatment rooms and three decontamination rooms.
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 Stanley Dental Practice is the principal dentist.
On the day of inspection, we collected 12 CQC comment cards filled in by patients.
During the inspection we spoke with two dentists, five dental nurses, one dental hygiene therapist 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 from 8am to 5pm.
Tuesday from 8am to 5pm.
Wednesday from 8am to 8pm.
Thursday from 8am to 5pm.
Friday from 8am to 5pm.
Saturday (once a month) 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.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider had systems to help them manage risk to patients and staff although there was scope for improvement. The provider did not provide a five-year fixed electrical wire test certificate. Weekly checks of emergency lighting, fire exits and fire extinguishers were not recorded. Patient safety alerts were not logged and we did not see evidence that recent alerts were shared with the team or acted upon if required.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures. We found that two clinical staff members had received standard Disclosure Barring Service checks (DBS) rather than the enhanced DBS checks and one dentist had a DBS on file that was completed at an alternate practice eight years ago; this had not been risk assessed. The practice had only received one reference rather than two for three members of staff which was not in accordance with their recruitment policy.
- 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 supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs. The practice offered extended hours appointments opening early from 8am Monday to Friday, opening late until 8pm on Wednesdays and opening one Saturday a month from 9am to 1pm.
- The provider had effective leadership and were adopting a culture of continuous improvement. The provider took ownership of the practice 18 months ago, at the time of our inspection only one staff member had received an appraisal although we saw evidence that all other staff appraisals had been scheduled for completion in August and September 2019.
- 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 systems for checking and monitoring premises maintenance taking into account relevant guidance and ensure that all services are well maintained. In particular ensuring that five-year fixed electrical wire testing is completed within relevant timeframes and ensuring weekly checks of the fire exits, emergency lighting and fire extinguishers are recorded.
- Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
- Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
- Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff.