We carried out this announced inspection on 12 June 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 two specialist dental advisors.
We told the NHS England area team and Healthwatch that we were inspecting the practice. Healthwatch did not provide any information. NHS England provided information about the type of contact they have with the practice.
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
Gentle Dental (Mylor Bridge) is in the village of Mylor Bridge, near Falmouth, Cornwall and provides NHS and private treatment to patients of all ages.
There is ramp access for people who use wheelchairs and pushchairs. Car parking spaces are available on the road by the practice.
The dental team includes one dentist, three dental nurses, one dental hygienist and a reception manager. The practice has two 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 Gentle Dental (Mylor Bridge) was the principal dentist.
On the day of inspection we collected 18 CQC comment cards filled in by patients. This information gave us a positive view of the practice.
During the inspection we met and spoke with one dental nurse and the reception manager. The practice was not open on the day we visited, so we were unable to meet with patients. We also interviewed the principal dentist and hygienist by phone on the day of the visit, as they were working in a different location. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open: Thursdays 1pm – 5.30pm and alternate Tuesdays 9.30am – 5.30pm. Outside of these hours patient are able to be seen by the same staff team working at the larger Newquay practice (approximately 20 miles away).
Our key findings were:
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- The practice had thorough staff recruitment procedures.
- The appointment system met patients’ needs.
- The practice asked staff and patients for feedback about the services they provided.
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. In particular embedding processes for monitoring the cleaning and sterilisation of dental instruments, systems for Legionella monitoring, systems for monitoring cleaning schedules at the practice, systems for monitoring emergency equipment and systems for monitoring the effectiveness of audit cycles.
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 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.
- Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
- Review the practice’s protocols and procedures for promoting the maintenance of good oral health taking into account guidelines issued by the Department of Health publication ‘Delivering better oral health: an evidence-based toolkit for prevention.’
- Review the system for identifying, disposing and replenishing of out-of-date dental materials stock.