Updated 7 May 2020
We carried out this announced inspection on 4 March 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 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 providing well-led care in accordance with the relevant regulations.
Background
One Dental is in Rochdale and provides NHS and private dental care and treatment for adults and children.
There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice.
The dental team includes four dentists (one of which is a foundation dentist), six dental nurses (three of which are trainees), two foundation dental hygiene therapists, a practice manager and an assistant manager. The practice has five treatment rooms. The practice hosts an orthodontic service which is registered separately.
The practice is owned by a company 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 One Dental is the practice manager.
On the day of inspection, we collected nine 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 three dentists including the foundation dentist, four dental nurses, the practice manager and the assistant manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday 9am to 5.30pm
Tuesday to Friday 8.30am to 5pm
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. On the day of inspection not all medicines and life-saving equipment were available as described in nationally recognised guidance. Immediate action was taken to obtain missing items.
- The provider had systems to help them manage risk to patients and staff.
- The provider had comprehensive safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which reflected current legislation.
- 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.
- 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 an area of notable practice.
- The team recognised safeguarding as a priority area due to the location of the practice and frequency of safeguarding issues locally. To facilitate this, the practice ensured all staff received face to face training to a higher level than necessary to enable them to quickly recognise any concerns, including criminal exploitation. Staff worked with the community safeguarding team, police community support officers and support workers to share concerns appropriately and ensured arrangements were in place to ensure patients in difficult family situations could access the practice for advice and care.
There were areas where the provider could make improvements. They should:
- Implement an effective system for recording, investigating and reviewing sharps incidents with a view to preventing further occurrences and ensuring that improvements are made as a result.
- Implement protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.
- Take action to implement any recommendations in the practice's Legionella risk assessment, 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.’