Updated 6 June 2017
We carried out this announced focussed inspection on 9 May 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.
Yeovil Dental Care received a comprehensive inspection on 28 November 2016 and we found there were significant concerns in how they dealt with incidents and we served a warning notice and told them to be compliant by 7 April 2017. We also served two requirement notices for regulation 17 good governance and regulation 18 staffing. They required improvement in ensuring the service was assessed and monitored to ensure risks were mitigated. This included the servicing of some equipment, ensuring policies and procedures met current legislation and clinical audits undertaken were shared and learned from. They also required improvement in staff support ensuring staff had regular appraisals and training.
The inspection was led by a CQC inspector who was supported by another CQC inspector who had access to a remote specialist dental adviser.
We told the NHS England area team that we were inspecting the practice. They did not provide any information.
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. During this inspection we reviewed the safe and well-led key questions to check if they were now meeting our standards.
Our findings were:
Are services safe?
We found that this practice was providing safe 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
Yeovil Dental Care is in Yeovil town centre and provides NHS and private treatment to patients of all ages.
There is no level access for patients who use wheelchairs and pushchairs. Patients were referred to a nearby accessible practice. There was no onsite car parking. However there were car parks close to the practice and local public transport was easily accessible.
The dental team includes four dentists (two of which were long term locums), four dental nurses (two of which were trainee dental nurses), one dental hygienist and two receptionists. The practice has five treatment rooms.
The practice is owned by a company 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 Yeovil Dental Care was 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.
The practice is open:
- Monday to Friday 8:30am to 5pm
- The practice is closed at weekends.
- There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed through the out of hours service.
Our key findings were:
- Staff understood how they should report all types of incidents, they were recorded appropriately and learned from and appropriate action taken.
- Staff were mostly up to date with mandatory training. There were a couple of gaps in infection control, information governance and fire safety which were being addressed by the practice manager.
- Equipment that sterilised dental instruments now received the appropriate daily checks and the compressor had now received its annual service.
- Staff immunity status had been confirmed by the practice manager and records held.
- Policies and procedures were reflective of local procedures and were under constant review to ensure they were kept up to date.
- Dentists were now using rubber dams in root canal treatments.
- The infection control lead had received specific training and was confident in her role.
- The practice had now installed a hearing loop for patients with a hearing impairment.
- Staff had received an appraisal in last year apart from two staff. The practice manager was completing these on the day of our inspection.
- There was a clinical audit plan for the year and clinical audits had been completed and learning items identified.
- Changes to the service had been implemented following patient comments.