Updated 29 March 2019
We carried out this announced inspection on 26 February 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
Apple Tree Dental is a well-established practice that offers both private and NHS treatment to both children and adults. The practice is one of eight that are part of the Antwerp House Group of dental practices in the Cambridge area.
The dental team includes five dentists, six dental nurses, three hygienists, two receptionists and a practice manager. There is ramp access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available.
The practice opens from 8am to 5pm Monday to Wednesdays, on Thursdays from 8am to 6pm and on Fridays from 8am to 4.30pm. It also opens every other Saturday.
The practice is owned by an individual who is the principal dentist of the Antwerp House Group. He has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
On the day of inspection, we collected 48 CQC comment cards filled in by patients and spoke with two other patients. We spoke with three dentists, three dental nurses, both receptionists, the relationship manager and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
Our key findings were:
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- Staff knew how to deal with emergencies and appropriate medicines and life-saving equipment were available.
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.
- Patients received their care and treatment from well supported staff, who enjoyed their work.
- Members of the dental team were up-to-date with their continuing professional development and were supported to meet the requirements of their professional registration.
- The practice provided good preventive care and supported patients to ensure better oral health.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- The practice took patients’ complaints seriously and responded to them appropriately to improve the quality of care.
- The practice had effective leadership and a culture of continuous audit and improvement.
There were areas where the provider could make improvements. They should:
- Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, in relation to the frequency of testing of the ultrasonic bath.
- Review the need to provide chairside support for the hygienist in line with GDC best practice guidance.