We carried out an announced comprehensive inspection on 11October 2016 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 not providing well-led care in accordance with the relevant regulations.
Background
Kenneth Ng Surgery Limited is a small, well-established practice that provides both NHS and private dentistry services to adults and children. Dr Kenneth Ng, who is the principal dentist, owns the practice. The practice has a team of two dentists and four dental nurses. There are three treatment rooms, a separate room for the decontamination of instruments, a reception area and two waiting rooms. The practice opens on Mondays to Fridays from 8.30am to 5.30pm, and on Saturdays by appointment.
The practice owner is registered with the Care Quality Commission (CQC) as an individual. 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.
Our key findings were:
- Patients commented on the effectiveness of their treatment, the professionalism of staff and the cleanliness of the environment. They reported that it was easy to get through on the phone and that they rarely waited long having arrived for their appointment.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- Appointments were easy to book and patients could access treatment and urgent and emergency care when required.
- Staff we spoke with felt supported by the practice owner, and there were regular practice meetings involving all staff. The practice listened to its patients and staff and acted upon their feedback.
- Essential information and evidence of some dental examinations and risk assessments was missing from patient dental care records.
- The practice’s recruitment process did not ensure that all relevant checks were undertaken before new staff began their employment.
We identified regulations that were not being met and the provider must:
- Ensure effective systems and processes are established to assess and monitor the service against the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. For example, this includes the management of significant events and patient safety alerts; the storage of dental care products; the management of substances hazardous to health, and ensuring dental care records are maintained appropriately giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
There were areas where the provider could make improvements and should:
- Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result
- Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
- Review the practice's recruitment policy and procedures to ensure they are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 so that necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.
- Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA).
- Review availability of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.