Archived: Victoria Road Dental Practice

We carried out this announced inspection on 12 May 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 a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information which we took into account.

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 providing well-led care in accordance with the relevant regulations.

Background

Victoria Road Dental practice is in Swindon and provides private treatment to patients of all ages.

To access the practice there is a small step from street level to the front door but not flat level access for people who use wheelchairs. The practice has installed a stair lift to the first floor for patients who have mobility difficulties. Treatment rooms are situated on either the first or lower ground floor. The practice is located on a main bus route and car parking spaces are available in a local public car park a short distance away.

The dental team includes three dentists, two dental nurses and two trainee dental nurses, three dental hygienists, one receptionist and a practice manager. The practice has four treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 21CQC comment cards filled in by patients and spoke with two other patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, two dental nurses, a dental hygienist and the practice manager who was also covering reception duties. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday: 8am to 1pm and 2pm to 6pm, Tuesday: 8am to 1pm and 2pm to 6pm, Wednesday: 8am to 1pm and 2pm to 4pm, Thursday: 8am to 1pm and 2pm to 6pm, Friday: 8am to 1pm and 2pm to 4pm, Saturday: Closed unless by prior arrangement. Sunday: Closed

Our key findings were:

• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The practice appeared visibly clean in most areas and well maintained although improvements were required to ensure all areas of the premises and furnishings were suitably clean.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice had infection control procedures which reflected published guidance. Improvements were required to ensure an Annual Statement in relation to infection prevention control was set up as required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance and sharps bins were suitably labelled on set up.
• Staff knew how to deal with emergencies. Medicines and equipment were available to manage medical emergencies, though improvements were required to ensure all medications and necessary equipment as per national guidelines were suitably available.
• The practice had systems to help them manage risk; improvements were required to ensure the fire safety risk assessment suitably included all hazardous gases, and the storage of and signage for these.
• The clinical staff provided patients’ care and treatment in line with current guidelines but we found that new patients routinely had a rotational panoramic X-ray.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice had systems in place to check equipment had been serviced regularly but we could not find a Critical Examination Report for one of the X-ray machines.
• The practice had a system to monitor and continually improve the quality of the service. This included a programme of clinical audits, although the analysis of the various grades of quality of X-rays appeared to be recorded incorrectly.
• The practice asked staff and patients for feedback about the services they provided although do not currently feedback to patients about any improvements they make.
• The practice dealt with complaints positively and efficiently.

There were areas where the provider could make improvements. They should:

• Review their infection control policy to include provision of an annual statement in relation to infection prevention control as required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review availability of equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the analysis of the grades for the quality of radiographs to ensure these are correctly recorded over each audit cycle and for each dentist.
• Review practice protocols for patient assessments and ensure they are in compliance with current legislation and take into account relevant nationally recognised evidence-based guidance.
• Review the practice’s systems in place for environmental cleaning taking into account current national guidelines.
• Review the fire safety risk assessment to include all hazardous gases, storage of and signage.
• 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 taking into account the guidance issued by the General Dental Council.