Archived: Richmond Road Dental Practice

Updated 17 September 2015

We carried out an announced, comprehensive inspection on 5 August 2015. The inspection took place over one day. The inspection was led by a CQC inspector. They were accompanied by a dentist Specialist Advisor.

We reviewed information received from the provider prior to the inspection. This included the practice’s statement of purpose and complaints received over the previous 12 months.

During our inspection visit, we reviewed policy documents, staff records and dental care records. We spoke with five members of staff, which included the principal dentist, two associate dentists, two dental nurses and the receptionist. We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. We reviewed the practice’s decontamination procedures of dental instruments and also observed staff interacting with patients in the waiting area.

Forty seven people provided feedback about the service. Patients we spoke with and those who completed CQC comment cards were very positive about the care they received from the practice. They were highly complementary about the friendly and caring attitude of the dental staff.

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 17 September 2015

We carried out an announced comprehensive inspection on 5 August 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

Richmond Road Dental Practice is located in Kingston, in the London Borough of Kingston. The premises are in a residential property, with the practice located on the ground floor only. The practice consists of two treatment rooms, a waiting area and reception and a staff kitchen. There are also toilet facilities shared between staff and patients.

The practice provides NHS and private dental services and treats both adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers, crowns, bridges, orthodontics, implants, dentures and oral hygiene.

The staff structure of the practice is comprised of the principal dentist who is also the practice manager, two associate dentists, three dental nurses and a receptionist who assists with administrative duties.

The practice is open 8am-5pm Monday to Thursday and 8am-1pm on Fridays.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 spoke with four patients on the day of our inspection and received 43 completed CQC comment cards. Patients we spoke with, and those who completed CQC comment cards, were very positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• The practice had good decontamination procedures for dental equipment and thorough checks of the decontamination equipment were carried out.

• Patients’ needs were assessed and care was planned in line with best practice guidance such as from the National Institute for Health and Care Excellence (NICE).

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• Patients were very positive about their care; they felt listened to, involved in their care and found practice staff helpful and friendly.

• From reviewing comments cards and speaking to patients, all patients felt they received an excellent and efficient service.

• The practice provided a responsive service; patients were able to access emergency appointments on the day they needed them.

• The practice had a stable leadership structure and staff told us they were well supported by the management team.

• The practice routinely completed a range of risk assessments to identify health and safety risks and provided regular servicing for most equipment, although some equipment and medicines checks were not always recorded.
• We found that the governance arrangements including management of some risks and learning and improving from incidents and accidents were not assured.

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

• Establish effective systems to record and monitor all medicines, emergency equipment, refrigerator thermometer temperatures and water temperatures.

• Ensure the systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors are robust and adequately documented.
• Ensure that practice policies are updated at regular intervals and updates are documented. 
• Review the practice’s protocols for use of two dental chairs in one treatment room and ensure all reasonable efforts are made to make sure that discussions about care and treatment cannot be overheard and, that risks of aerosol contamination are minimised.
• Ensure all audits have documented learning points and the resulting improvements can be demonstrated.