Montgomery House

Updated 7 January 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection was led by a CQC inspector who had access to remote advice from a specialist advisor.

We informed the local NHS England area team and Healthwatch Sheffield that we were inspecting the practice; however we did not receive any information of concern from them.

During the inspection we spoke with three patients, two dentists, the dental hygiene therapist, two qualified dental nurses, one trainee dental nurse and the practice manager. To assess the quality of care provided we looked at practice policies and protocols and other records relating to the management of the service.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 7 January 2016

We carried out an announced comprehensive inspection on 18 November 2015 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Montgomery House is situated in the Netherthorpe area of Sheffield. It offers mainly NHS treatment to patients of all ages but also offers private dental treatments. The services provided include preventative advice and treatment, routine restorative dental care and dental implants.

The practice is located on the first floor of the premises. There are four surgeries, a decontamination room, a waiting area and a reception area.

There are three dentists, a dental hygienist, a dental hygiene therapist, six dental nurses (one of whom was a trainee), a practice manager and a clinical director. The dental nurses also share reception duties. The practice also employ a cleaner.

The opening hours are Monday, Tuesday and Friday 8-30am to 5-30pm, Wednesday and Thursday 8-30am to 7-00pm.

The practice owner is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

During the inspection we spoke with three patients who used the service and reviewed 50 completed CQC comment cards. Patients we spoke with and those who completed comment cards were positive about the care they received about the service.

Our key findings were:

• Staff received training appropriate to their roles.
• Dental care records were detailed and showed that treatment was planned in line with current best practice guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit.
• Patients were treated with care, respect and dignity.
• There were clearly defined leadership roles within the practice and staff told us that they felt supported, appreciated and comfortable to raise concerns or make suggestions. Staff received training appropriate to their roles.
• The practice did not have buccal midazolam in the emergency medicines kit.
• Emergency equipment was not checked in line with current guidance.
• Tests on the autoclaves were not carried out in line with current guidance.

There were areas where the provider could make improvements and should:

• Conduct and document the automatic control test and steam penetration test at the required intervals in line with HTM 01-05 guidance.
• Conduct the IPS audit every six months in line with HTM 01-05 guidance.
• Conduct a weekly check on the AED and the emergency oxygen cylinder.
• Aim to thoroughly check the medical emergency kit for out of date equipment.
• Aim to repair the floor in surgery three.
• Aim to record in the X-ray machine service record when adjustments to the dose have been made.
• Aim to analyse the data collected from the patient satisfaction survey.

We saw evidence after the inspection that all these points had been immediately addressed.