Archived: Spilsby Dental Surgery

Updated 13 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection took place on 1 March 2016 and was led by a CQC inspector and supported by a specialist dental advisor. Prior to the inspection, we asked the practice to send us some information that we reviewed. This included the complaints they had received in the last 12 months, their latest statement of purpose, and the details of their staff members including proof of registration with their professional bodies.

During the inspection, we spoke with the dentist, dental nurse, receptionist and reviewed policies, procedures and other documents. We reviewed 15 comment cards that we had left prior to the inspection, for patients to complete, about the services provided at the practice.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 13 April 2016

We carried out an announced comprehensive inspection on 1 March 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Spilsby Dental Surgery is a single surgeon dental practice in the centre of Spilsby which is a village in Lincolnshire. The practice is in a grade two listed building which has limitations on modernisations that can be made however the building was fit for purpose. There are two treatment rooms (one of which is used one day a week by a self-employed hygienist) a decontamination room, a reception area, waiting room, office, staff toilet and patient toilet. There is also a staff room on the first floor of the practice. Access to the practice areas are all on the ground floor. There is pay and display parking within walking distance. The building is accessed from the street down a side alley. Patients with limited mobility or wheelchairs are assisted by staff members to open the door to the practice. Once inside the practice there is access to both treatment rooms. The toilet facilities for patients are not suitable for wheelchair access.

There is one dentist, three dental nurses (who also cover reception), one receptionist and a practice manager who is also a qualified dental nurse. The practice also has a hygienist that is self-employed that works in the practice for one day per week.

The practice provides NHS and private dental treatment to adults and to children. The NHS contract for the practice is for three days per week, Tuesday to Thursday from 8.30am to 5pm for and Monday 8.30am to 5pm for private patients although the practice does see a mixture of patients on these days. The practice closes on Fridays. The providers told us that the contract that they were given from the NHS was not big enough to meet the number of patients in the catchment area and there were approximately 200 patients on the NHS waiting list.

The company consists of two partners that own the practice are also the registered managers. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered dentists, they are ‘registered persons’. Registered persons 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 managers were supported in their role by the practice manager.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 15 patients about the services provided. The feedback reflected positive comments about the staff and the services provided. Patients commented that the practice was clean and tidy and that it was welcoming and friendly. They said that staff offered an excellent and professional service and were polite, attentive and caring. Patients said that explanations about their treatment were clear and that they were given time to ask questions and that all options were fully explained. Patients who were nervous commented how the dentist put them at ease and was reassuring, understanding and that any questions were answered.

Our key findings were:

• There were sufficient numbers of suitably qualified staff to meet the needs of patients as far as possible within the confines of the contract.
• Infection control procedures were in place and staff had access to personal protective equipment.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks.
• Patients were treated with dignity and respect and their confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum where possible.
• The practice was well-led and staff felt involved and worked as a team.
• Staff had been trained to deal with medical emergencies.
• Governance systems were effective and policies and procedures were in place to provide and manage the service.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• All staff were clear of their roles and responsibilities.
• Audits and assessments had taken place and action plans were developed to address any identified shortfalls or to improve the service.
• There was an effective process for the reporting of incidents, accidents or near misses with learning and actions taken shared with staff.
• Servicing and checks of equipment had been completed in recommended timescales such as servicing of autoclave and x-ray equipment.

There were areas where the dentist could make improvements and should:

• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance in relation to the chair in the second treatment room.