Updated 11 August 2022
We carried out this announced focused inspection on 20 July 2022 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 adviser.
To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:
• Is it safe?
• Is it effective?
• 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 to be visibly clean and well-maintained.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to help them manage risk to patients and staff; we discussed how governance and oversight of these could be improved.
- 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. Records relating to a small number of checks carried out before staff started work, were not available.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The dental clinic had information governance arrangements.
Background
Schofield and Pickup is in Clitheroe, Lancashire 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 practice has made adjustments to support patients with additional needs. For example, the provision of a portable hearing loop for patients with hearing difficulties and sloped access to and from the practice for those with limited mobility.
The dental team includes seven dentists, two oral/maxillofacial surgeons, two dental therapists, three dental hygienists, 12 dental nurses, two of whom are trainees, two receptionists, one administrative team leader, and a practice manager. The practice has nine treatment rooms.
During the inspection we spoke with three dentists, two dental nurses, 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, Wednesday and Thursday from 9am to 6pm; Tuesday from 9am to 8pm; Friday from 9am to 5pm. Saturday appointments can be arranged where necessary, based on patient need.
There were areas where the provider could make improvements. They should:
Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular:
- For oversight of electrical safety in the practice, particularly in relation to the five-year fixed wiring condition report, and that this covers the treatment rooms in the practice.
- For the full assessment of fire safety in the building, including the placement of required signage.
Improve the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff; and that action is taken to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
Take action to ensure the practice stores records relating to people employed and the management of regulated activities in compliance with legislation and take into account current guidance.