We carried out this announced inspection of G M Burr & Associates on 28 April 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 Care Quality Commission inspector who was supported by a specialist dental adviser.
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
G M Burr & Associates is in Welling, in the London Borough of Bexley, and provides approximately 33% NHS and 67% private treatment to 5000-6000 patients of all ages.
The practice is based on the first floor of a converted house and there is no level access for people who use wheelchairs and pushchairs. There is public car parking available near the practice with spaces reserved for disabled badge holders.
The dental team includes three dentists, four dental nurses, a practice manager and a receptionist. The practice has three treatment rooms.
The practice is owned by an individual. 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 feedback from 49 patients. This information gave us a positive view of the practice.
During the inspection we spoke with three dentists, two dental nurses, a receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open on Mondays to Fridays from 9am to 12.30pm, and from 1.30pm to 5.30pm. It is closed on weekends and bank holidays.
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 clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- The appointment system met patients’ needs.
- Staff felt involved and supported and worked well as a team.
- The practice asked staff and patients for feedback about the services they provided.
- The practice dealt with complaints positively and efficiently.
- The practice had infection control procedures, though they did not always reflect published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available, though improvements were needed in relation to monitoring processes.
- The practice had systems to help them manage risk, though improvements were needed in relation to ensuring risk assessments were conducted thoroughly and by qualified professionals.
- The practice was not visibly clean or well-maintained in all areas.
- Improvements could be made to ensure that all staff received fire safety training and regular infection control training updates.
Shortly after the inspection the practice took steps to begin to address the issues we identified.
We identified regulations the provider was not meeting. They must:
- Ensure systems are in place to assess, monitor and improve the quality of the service.
- Ensure the practice establishes an effective system to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.
There are areas where the provider could make improvements. They should:
- Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, and supervision of all staff.