Archived: Painswick House Dental Practice

We carried out this announced inspection on 18 June 2018 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.

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 providing well-led care in accordance with the relevant regulations.

Background

Painswick House Dental Practice is in Cheltenham, Gloucestershire and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available at the practice.

The dental team includes five dentists, five dental hygienists, six dental nurses one of whom is also a receptionist, three receptionists and a practice manager. The practice has eight treatment rooms, a decontamination room, waiting room and reception area. The practice is open Monday to Thursday 8:30 – 5:00 and Friday 8:30 – 4:00.

The practice is owned by a partnership 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 Painswick House Dental Practice was the practice manager.

On the day of inspection we collected 39 CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, three dental nurses, a dental hygienist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice staff appeared clean and well maintained.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.
• The practice did not have evidence of immunity against Hepatitis B for three clinical staff.
• The practice was not registered to receive safety alerts.
• The practice had not undertaken radiography audits.
• The practice did not have accessible information for people with a disability, impairment or sensory loss,
• The practice did not investigate and review incidents with a view to preventing further occurrences.

There were areas where the provider could make improvements. They should:

• Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• Review the practice’s protocols to ensure audits of radiography are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.
• Review the Accessible Information Standard to ensure people who have a disability, impairment or sensory loss get information in a format that they can access and understand.
• Review the practice’s system for investigating and reviewing incidents with a view to preventing further occurrences and ensuring that improvements are made as a result.