Updated 9 June 2023
We carried out this announced comprehensive inspection on 31 May 2023 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 practice 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 specialist dental advisor.
To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:
- The dental clinic appeared clean and well-maintained.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with medical emergencies. Most medicines and life-saving equipment were available.
- The practice had systems to manage risks for patients, staff, equipment and the premises. Minor shortfalls were found in relation to legionella management.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice had staff recruitment procedures which reflected current legislation.
- Clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system worked efficiently to respond to patients’ needs.
- The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
- There was effective leadership however, shortfalls were found in the oversight of staff training.
- Staff felt involved, supported and worked as a team.
- Staff were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The practice had information governance arrangements.
Background
This report is about Brookhouse Dental Practice in Gnosall, Staffordshire and provides NHS and private dental care and treatment for adults and children.
The dental practice is situated on the ground floor of a health centre. There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.
The dental team includes 2 dentists, 4 dental nurses, 1 dental therapist, 1 practice manager and 2 receptionists. The practice has 3 treatment rooms.
During the inspection we spoke with 1 dentist, 2 dental nurses, the dental therapist, 1 receptionist and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open: Monday to Friday from 8.30am until 5pm.
There were areas where the provider could make improvements. They should:
- Implement an effective system of checks of medical emergency equipment and medicines taking into account the guidelines issued by the Resuscitation Council (UK) to ensure all equipment is in date.
- Take action to ensure the practice's Legionella risk assessment reflects the premises, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular the management of the temperature of the hot and cold water.
- Implement practice protocols and procedures to ensure staff are up to date with their mandatory training and their continuing professional development.
- Take action to ensure audits of radiography are undertaken at regular intervals to improve the quality of the service taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment.