We carried out this announced inspection on 17 October 2017 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 CQC inspector who was supported by a specialist dental adviser.
We told the NHS England area team that we were inspecting the practice. They did not provide any information for us to take into account.
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 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 not providing well-led care in accordance with the relevant regulations.
Background
Oasis Dental Care - Erdington is located in Birmingham and provides NHS and private treatment to patients of all ages.
The treatment rooms are located on the first floor so access is limited for people who use wheelchairs and pushchairs. Car parking spaces are available near the practice.
The dental team includes five dentists, four dental nurses (one of whom is a trainee), one dental hygienist and two receptionists. The team is supported by a practice manager. Additional dental nursing staff are also transferred to this practice from their sister practice when required. The practice has three treatment rooms.
The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Oasis Dental Care - Erdington was the practice manager. At the time of the inspection visit, our records showed the practice had registered two persons as their registered managers at Oasis Dental Care – Erdington. We discussed this with the practice manager and they informed us they were the only registered manager as the other registered manager had left the company. They assured us they would update their registration details.
On the day of inspection we collected one CQC comment card filled in by a patient and spoke with four other patients. This information gave us a positive view of the practice.
During the inspection we spoke with two dentists, three dental nurses, one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open between 8am and 7pm on Mondays and Tuesdays. It is open between 9am and 7pm on Wednesdays and between 9am and 5pm on Thursdays and Fridays.
Our key findings were:
- The practice was visibly clean but some improvements were required with respect to the flooring, work surfaces and walls in clinical areas. One item of equipment was soiled.
- The practice had infection control procedures which reflected published guidance but improvements were required relating to audits, instrument storage and disinfection of laboratory work.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had limited systems to help them manage risk.
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Some of the policies were obsolete and required updating.
- The practice had limited staff recruitment procedures. There was no written policy and some essential documentation was not available in the staff recruitment files.
- 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.
- The appointment system met patients’ needs.
- Staff felt involved, supported and worked well as a team.
- The practice asked staff and patients for feedback about the services they provided.
- The practice dealt with complaints positively and efficiently.
We identified regulations the provider was not meeting. They must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
Full details of the regulations the provider was not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.