Archived: Foregate Street Dental Surgery

Updated 3 March 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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection took place on 2 February 2016 and was conducted by a CQC inspector and a dental specialist advisor.

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.

Prior to the inspection we asked the practice to send us some information which we reviewed. This included any complaints they had received in the last 12 months, their latest statement of purpose, the details of their staff members, their qualifications and proof of registration with their professional bodies.

We also reviewed information we held about the practice and found there were no areas of concern. During the inspection we spoke with dentists, a therapist, dental nurses, a receptionist and the practice manager. We reviewed policies, procedures and other documents. We reviewed 17 CQC comment cards that we had left prior to the inspection, for patients to complete, about the services provided at the practice and spoke to four patients on the day of inspection.

Updated 3 March 2016

We carried out an announced comprehensive inspection on 2 February 2016 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

The practice, which is currently being refurbished, is situated in Chester city centre. The practice has three dentists, one dental therapist, three qualified dental nurses, two trainee dental nurses, receptionists and a practice manager. The practice provides primary dental services to predominately NHS patients and some private patients. The practice is open:

Monday – Thursday 8am – 1pm and 2pm – 5pm

Friday 8am – 1pm

The principal dentist is the registered provider. A registered provider is registered with the Care Quality Commission to manage the service. 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.

We received feedback from 21 patients about the service. The 17 CQC comment cards seen and four patients spoken to reflected very positive comments about the staff and the services provided. Patients commented that the practice appeared clean and tidy and they found the staff very caring, friendly and professional. They had trust and confidence in the dental treatments and said explanations from staff were clear and understandable. Emergency appointments were available each day and appointments usually ran on time.

Our key findings were:

• The practice recorded and analysed accidents and complaints and cascaded learning to staff when they occurred. They had not recorded any significant events in the last 12 months; however procedures and templates were in place for significant event reporting and analysis.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies and emergency medicines and emergency equipment were available.
• Infection prevention and control procedures were in place.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and their confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The practice staff felt valued, involved and worked as a team.
• The practice took into account any comments, concerns or complaints and used these to help them improve.

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

• Reviewing the storage of dental care records to ensure they are stored securely and meet health and safety and fire regulations in accordance with the Department of Health’s code of practice for records management (NHS Code of Practice 2006) and other relevant guidance about information security and governance.
• Improving staff meetings to include dissemination of lessons learnt from significant events and complaints and sharing improvements from audits and service developments.
• Formalising the lead role for safeguarding and ensuring the lead is suitably qualified and experienced to undertake the role.
• Securing access to the local decontamination unit (LDU).
• Installing suitable splashbacks in the LDU to minimise the risk of cross infection.
• Carrying out fire safety training annually and fire drills six monthly.

• Maintaining accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal reference taken and ensuring recruitment checks, including references and photographic identification, are suitably obtained and recorded.

We also found an area of notable practice:

• We observed the dentist carrying out root canal treatment on a patient using a dedicated dental microscope. This greatly enhanced the view of the root canal and enabled more precise treatment to be carried out.