Speke Dental Practice

We carried out this announced inspection on 26 November 2019 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

Speke Dental Practice is based in Speke, Liverpool and provides NHS and private dental care and treatment for adults and children. The dental centre is located in a purpose-built health centre.

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. There is a lift in the building which serves the dental practice on the first floor.

The dental team includes two dentists, four dental nurses, one of whom is a trainee, and a patient treatment co-ordinator. The practice team are supported by a practice manager. The practice has three treatment rooms, two of which are used and maintained by the practice. The third treatment room is used and maintained by a separate provider of dental treatment.

The practice is owned by an individual. They 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 Speke Dental Practice is the practice manager.

On the day of inspection, we collected 83 CQC comment cards filled in by patients. All feedback provided was highly positive about all aspects of the service provided.

During the inspection we spoke with two 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 to Friday from 9am to 5pm.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies.
• Not all recommended life-saving equipment was available. This was ordered on the day of our inspection.
• All recommended emergency medicines were available.
• The provider had systems to help them manage risk to patients and staff. Some of this required review.
• The provider had 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 in place for the day to day management of the practice.
• Measures had been introduced to provide greater clinical oversight, through the corporate structure the practice is linked to, to drive 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 any complaints positively and efficiently.
• The provider had information governance arrangements.

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Take action to ensure dentists are aware of the guidelines issued by the British Endodontic Society for the use of dental dam for root canal treatment.
• Improve and develop the practice's current performance review systems and have an effective process established for the on-going assessment and supervision of all staff. In particular for the dentists working at the practice, to include checks on levels of professional indemnity insurance to ensure cover provided matches contractual working hours/sessions.
• Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular that all appliances connected to the water piping servicing the dental treatment rooms, maintained as described in the Legionella risk assessment; and that employer liability insurance in place covers the practice, as registered with the Care Quality Commission.
• Implement a system to ensure patient referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner and not lost.