Manor Dental Clinic

We carried out an announced comprehensive inspection on 1 November 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 not providing well-led care in accordance with the relevant regulations.

Background

Manor Dental Care is a dental practice providing NHS and private treatment for both adults and children. The practice is based on the first floor of commercial premises in Oxford.

The practice has four dental treatment rooms and a separate decontamination room used for cleaning, sterilising and packing dental instruments. The practice is situated on the first floor of the building; patients with limited mobility are sign-posted to nearby dental services with ground floor access.

The practice employs two dentists, two locum dentists, one hygienist, two dental nurses of which one is a trainee, one receptionist and a part time practice manager.

The practice’s opening hours are 8.30am to 1pm and 2pm to 5.30pm Monday to Friday, 8.30am to 1pm and 2pm to 7pm on Thursday and 8.30am and 2pm on Saturday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service.

There was no registered manager at the time of our inspection at this location. We were told that the current Practice Manager had resigned and was leaving the practice the day of our visit. 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.

We obtained the views of five patients on the day of our inspection.

Our key findings were:

• The dentists we spoke with had an ethos of providing patient centred dental care in a relaxed and friendly environment.
• Appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• The practice appeared clean and properly maintained.
• There was appropriate equipment for staff to undertake their duties, and equipment was properly maintained.
• Infection control procedures followed published guidance.
• Staff we spoke with understood the issues around safeguarding adults and children living in vulnerable circumstances.
• There was a process in place for the reporting of untoward incidents in the practice. Although the lack of records pertaining to incidents and accidents indicated that there may be under-reporting of such occurrences.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff we spoke with were committed to providing a quality service to their patients.
• The practice manager role was carried out on a ‘dual location’ basis. Due to the geographical distance between the two practices it was difficult for the practice manager to be fully effective in their role. As a result, staff were not always confident that the practice was effectively managed.
• We found that there were deficiencies in the operation of some clinical governance systems. This included shortfalls in the systems to mitigate the risk of fire, maintaining certain records and obtaining feedback from patients on the quality of services provided by the practice.
• Information from 13 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

We identified regulations that were not being met and the provider must:

• Ensure that a system for collating the records of training, learning and development needs of staff members is established.
• Establish an effective system for obtaining patient feedback on the quality of services provided by the practice.

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

• Consider providing the hygienist with the support of an appropriately trained member of the dental team.
• Review the availability of hearing loops for patients who are hard of hearing.
• Review staff understanding of the availability of an interpreter service for patients who do not speak English as their first language.
• Provide an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: Code of Practice about the prevention and control of infections and related guidance.
• Consider the provision of an external name plate providing details of the dentists working at the practice including their General Dental Council (GDC) registration number in accordance with GDC guidance from March 2012.
• Review patient information to ensure that the opening hours are accurately recorded on the practice leaflet and NHS Choices website.
• Review the frequency of staff meetings to ensure that staff have an opportunity to take part in shared learning and provide feedback regularly.
• Review arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as Public Health England (PHE).