Background to this inspection
Updated
23 February 2017
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.
We carried out an announced, comprehensive inspection on 16 January 2017. The inspection team consisted of a Care Quality Commission (CQC) inspector and a dental specialist advisor.
Before the inspection we asked for information to be sent, this included the complaints the practice had received in the last 12 months; their latest statement of purpose; the details of the staff members, their qualifications and proof of registration with their professional bodies.
We reviewed the information we held about the practice and found there were no concerns.
We reviewed policies, procedures and other documents. We received feedback from 11patients about the dental service.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
These questions therefore formed the framework for the areas we looked at during the inspection.
Updated
23 February 2017
We carried out an announced comprehensive inspection on 16 January 2017 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
Eyre Street Dental is located on two floors of premises situated in the centre of Clay Cross in north Derbyshire. There are seven treatment rooms, two of which are on the ground floor. The practice provides mostly NHS dental treatments (98%). There is a free car park close to the practice.
The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.
The practice’s opening hours are – Monday: 9 am to 6 pm; Tuesday: 8:30 am to 7:30pm; Wednesday: 8:30 am to 5:30 pm; Thursday: 8:30 am to 7 pm and Friday: 8:45 am to 5:30 pm
Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients can telephone the NHS 111 telephone number. There is an out-of-hours dental service based in Chesterfield which patients could also access for urgent dental treatment.
The principal dentist 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.
The practice is registered with the Care Quality Commission (CQC) as a partnership.
The practice has six dentists; three hygiene therapists; eight qualified dental nurses; three trainee dental nurses; three receptionists; and one practice manager.
Before the inspection we sent CQC comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received responses from 11 patients through both comment cards and by speaking with them during the inspection. Those patients provided positive feedback about the services the practice provides.
Our key findings were:
- The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
- There were systems to record accidents, significant events and complaints.
- Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
- There were effective systems at the practice related to the Control of Substance Hazardous to Health (COSHH) Regulations 2002.
- The consent policy made reference to the Mental Capacity Act 2005.
- Patients were able to access emergency treatment when they were in pain.
- Patients provided positive feedback about their experiences at the practice. They told us they were treated with dignity and respect and had no problem getting an appointment to suit their needs.
- Dental care records did not always demonstrate that the dentists had completed a risk assessment in relation to caries (tooth decay) and periodontal disease (gum disease).
- Patients’ confidentiality was protected within the practice.
- The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
- The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
- There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns about a colleague’s practice.
- The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.
- The practice did not have an induction hearing loop.
There were areas where the provider could make improvements and should:
- Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
- Review the practice protocols and adopt an individual risk based approach to patient recalls giving due regard to National Institute for Health and Care Excellence (NICE) guidelines.
Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and consider installing a hearing induction loop to assist patients and visitors who used a hearing aid.