Mr Crawford Black - Church Road

We carried out this announced inspection on 3 January 2018 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 Cheshire and Merseyside area team that we were inspecting the practice. We did not receive any information of concern from them.

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 not providing well-led care in accordance with the relevant regulations.

Background

Mr Crawford Black – Church Road is close to the centre of Bebington and provides dental care and treatment to adults and children on an NHS and/or privately funded basis.

There is one step at the front entrance to the practice. Car parking is available near the practice. The practice has four treatment rooms.

The dental team includes a principal dentist, an associate dentist, a dental hygienist, four dental nurses, and two receptionists. The team is supported by a practice manager, who is also a registered dental nurse.

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.

We received feedback from 26 people during the inspection about the services provided. The feedback provided was positive about the practice.

During the inspection we spoke to both dentists, dental nurses, receptionists and the practice manager. We looked at practice policies, procedures and other records about how the service is managed.

The practice is open:

Monday, Tuesday and Thursday 9.00am to 6.00pm, (Monday and Tuesday from 08.30am by appointment)

Wednesday and Friday 9.00am to 5.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medical emergency medicines and equipment were available.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
• The practice had a management structure. Staff felt involved and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had arrangements in place to help them manage most risks. Potential risks relating to Legionella and staff Hepatitis B immunisation response had not been fully assessed and acted on.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children. Some staff had not received training within the recommended time interval.
• The practice did not have effective staff recruitment procedures in place.
• Not all the clinicians followed current guidelines when providing patients’ care and treatment.
• The practice had a procedure in place for dealing with complaints. Contact details for alternative organisations patients could complain to were not readily available.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• Ensure the specified information is available regarding each person employed.

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review the practice’s safeguarding policy and staff training ensuring all staff are trained to an appropriate level for their role and aware of their responsibilities.
• Review awareness of current evidence-based clinical guidance in relation to patient recalls, X-rays, the maintenance of good oral health, the use of rubber dam in root canal treatment, and the content of dental care records.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment of all staff.
• Review the practice’s complaint handling procedures and ensure contact information for NHS England is provided for patients who do not wish to complain to the practice directly or are not satisfied with the way the practice has handled their complaint.
• Review the practice’s arrangements for communicating information to staff and service users about the quality and safety of the service.