The Care Quality Commission
  • Dentist
  • Dentist

Boulevard Dental Practice

43 Boulevard, Weston Super Mare, Somerset, BS23 1PG (01934) 636564

Provided and run by:
Mr. Liam Costello

Important: The provider of this service changed. See old profile

All Inspections

19 March 2018

During an inspection looking at part of the service

We carried out a focused inspection of Boulevard Dental Practice on 19 March 2018.

We carried out the inspection to follow up concerns we originally identified during a comprehensive inspection at this practice on 27 June 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

At a comprehensive inspection we always ask the following five questions to get to the heart of patients’ experiences of care and treatment:

  • Is it safe?
  • Is it effective?
  • Is it caring?
  • Is it responsive to people’s needs?
  • Is it well-led?

When one or more of the five questions is not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

At the previous comprehensive inspection we found the registered provider was providing safe, effective, caring and responsive care in accordance with relevant regulations. We judged the practice was not providing well-led care in accordance with regulation17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Boulevard Dental Practice on our website www.cqc.org.uk.

We also reviewed the key question of safe as we had made recommendations for the provider relating to this key question. We noted improvements had been made.

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements to put right the shortfalls and deal with the regulatory breach we found at our inspection on 27 June 2017.

27 June 2017

During a routine inspection

We carried out this announced inspection on 27 June 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.

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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Boulevard Dental Practice is in Weston-Super-Mare and provides private and some NHS treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are limited and there is on road parking available near the practice. There are no parking spaces identified for patients with disabled badges.

The dental team includes two dentists, two dental nurses, one dental hygienist, and one receptionist. The practice has three 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 four CQC 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, and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday – Thursday 9.00am – 1.00pm and 2.00pm – 5.30pm.

Friday 09.00am -1.00pm. Saturdays and late evenings by prior arrangement. The practice is closed at weekends. Out of hours information is displayed on the website and available via the telephone answering service.

Our key findings were:

  • The practice was clean and well maintained.
  • The practice had infection control procedures in place which reflected published guidance.
  • The practice had safeguarding processes in place and staff mostly knew their responsibilities for safeguarding adults and children. Not all staff had received safeguarding training.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The practice had limited systems to help them manage risk including the management of medicines supplied by the practice.
  • 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 and dedicated emergency appointments were available.
  • The practice used digital radiographs to help explain necessary treatment to patients.
  • The practice leadership was limited and lacked effective systems to ensure the safety and quality of the delivery of regulated activities.
  • Most staff felt involved and supported by the practice management.
  • The practice recruitment procedures did not meet the legislative requirements for the safe recruitment of staff.
  • The practice asked patients for feedback about the services they provided through the Friends and Family test only.
  • The practice dealt with complaints positively and efficiently.

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

  • Ensure that there are systems in place for assessing, monitoring and mitigating all risks. Ensure risk assessments are adapted to reflect the risks in the practice and how they would be mitigated.

  • Ensure the training, learning and development needs of individual staff members are monitored and maintained at appropriate intervals.

  • Ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff.

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. They should:

  • Review the arrangements for the storage of the oxygen and implement suggestions as outlined in the Fire Risk assessment.

21 November 2012

During an inspection looking at part of the service

This inspection was carried out to follow up concerns raised at the last inspection on 31 January 2012. At the previous inspection we had suggested improvements in relation to recording checks on emergency equipment and medicines.

We had also set actions for improvement for the provider to improve their safeguarding practices to protect vulnerable adults and children and to improve on how they checked and audited infection control practices.

We did not need to speak to people who used the service to enable us to check compliance of the actions set from the last inspection.

We found the provider had taken action to address some of these concerns. They had put systems in place to ensure necessary checks were carried out on their emergency medicines. Although some apparatus to aid breathing was out of date, which the provider assured us they would replace immediately.

We found the provider had risk assessed its staff on whether it was necessary to carry out criminal background checks on its staff to ensure the safety of people who used the service. All staff had received training for the protection of vulnerable adults and children. The provider now had information available for staff on safeguarding.

We found the provider now kept records of maintenance of the sterilising equipment and checks carried out by the dental nurses. The provider did not have evidence of an audit carried out against the appropriate guidance as required.

31 March 2012

During a routine inspection

We spoke with four people who used the practice and they told us they were very happy with the service provided. They felt they were given enough information about their treatment options and relevant fees as well as time to ask questions in order to make an informed decision.

One person told us 'he is excellent and I don't want him to retire'. Another person told us they had a 'whimpish' daughter and he was very good with her. A third person told us they had only recently started using the service and they were very nervous of dentists. They told us 'he is very good and always talks to me. He lets me know what he is doing and why'.

People told us the staff were friendly and treated them with respect and their privacy was maintained. All people we spoke with felt confident and comfortable with the practice staff.

We examined a sample of case records and saw they included medical histories and contained details of current treatments for the people concerned. We observed the contact details for emergency treatment were displayed in the reception area of the practice, and were told emergency appointments were always available.

The practice had systems in place for the decontamination of instruments. Staff had been trained to follow infection prevention and control precautions.

The practice had disabled access via a ramp. Once in the surgery the facilities offered by the practice were all on one level.

People were not protected from abuse through regular staff training and awareness in protecting vulnerable adults, children and young people. Staff were not aware of how to protect people through the use of the Mental Capacity Act 2005.