Bamford Dental Practice

We undertook a follow up desk-based inspection of Bamford Dental Practice on 13 February 2020. This inspection was carried out to review in detail the evidence of the actions taken and sent to us 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 had remote access to a specialist dental adviser.

We undertook a comprehensive inspection of Bamford Dental Practice on 16 January 2020 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 well-led care and was in breach of regulations 17 and 19 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 Bamford Dental Practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

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

Our findings were:

Are services well-led?

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

The provider had made immediate improvements in relation to the regulatory breaches we found at our inspection on 16 January 2020 and sent evidence of documents that were in place but not available on the inspection day.

Background

Bamford Dental Practice is in Rochdale and provides NHS and private dental care and treatment for adults and children. The practice also provides private dental implants, sedation, endodontics, orthodontics and NHS orthodontic care to children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. A large car park is available, including dedicated parking for people with disabilities.

The dental team includes 12 dentists, 19 dental nurses (two of whom are clinical managers), a treatment co-ordinator, five dental hygiene therapists, an orthodontic therapist, six receptionists and a business manager. The practice has 10 treatment rooms.

The practice is owned by anorganisation and as a condition of registration must have a person registered with the CQC 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 Bamford Dental Practice is one of the partners.

The practice is open:

Monday, Tuesday and Thursday 9am to 5.30pm

Wednesday and Friday 9am to 5pm

Saturday 9am to 12.30pm (by appointment only)

Our key findings were:

• The provider had effective leadership and a culture of continuous improvement.

• Systems to identify risk were reviewed immediately after the initial inspection in January and systems implemented to manage these.

• The recruitment procedures were reviewed to ensure all essential checks were carried out for new employees and agency staff.

• The practice implemented systems to obtain evidence of staff training and competency appropriate to their role.

We carried out this announced inspection on 16 January 2020 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 Care Quality Commission, (CQC), inspector who was supported by a second CQC inspector and 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

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

Are services well-led?

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

Background

Bamford Dental Practice is in Rochdale and provides NHS and private dental care and treatment for adults and children. The practice also provides private dental implants, sedation, endodontics, orthodontics and NHS orthodontic care to children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. A large car park is available, including dedicated parking for people with disabilities.

The dental team includes 12 dentists, 19 dental nurses (two of whom are clinical managers), a treatment co-ordinator, five dental hygiene therapists, an orthodontic therapist, six receptionists and a business manager. The practice has 10 treatment rooms.

The practice is owned by an organisation and as a condition of registration must have a person registered with the CQC 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 Bamford Dental Practice is one of the partners.

On the day of inspection, we collected 47 CQC comment cards filled in by patients. These provided a positive view of the dental team and care provided by the practice.

During the inspection we spoke with six dentists, dental nurses including a clinical manager, a dental hygiene therapist, the orthodontic therapist, a receptionist and the business manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Tuesday and Thursday 9am to 5.30pm

Wednesday and Friday 9am to 5pm

Saturday 9am to 12.30pm (by appointment only)

Our key findings were:

• The practice appeared to be visibly clean, tidy 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 systems to identify and manage risk to patients and staff could be reviewed.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The recruitment procedures did not ensure all essential checks were carried out for new employees and agency staff. Evidence of professional indemnity was not consistently obtained from clinical 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.
• Systems to obtain evidence of training and competency were not effective.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked 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 information governance arrangements.

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 recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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

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

• Implement protocols and procedures in relation to the Accessible Information Standard to ensure that that the requirements are complied with.