Fosse Dental Care

We carried out this announced inspection on 11 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.

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

The practice is located in Leicester in the East Midlands and provides NHS and private treatments to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including one allocated for patients who are blue badge holders, are available at the practice.

The dental team includes nine dentists, five dental nurses, four trainee dental nurses, a decontamination assistant (who works in the decontamination of dental instruments), four receptionists and a practice manager.

The practice has seven treatment rooms; four of these are on the ground floor.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. At the time of our inspection, the practice did not have a registered manager in post. We discussed this with the provider and they informed us they would take immediate action to address this.

On the day of inspection we collected 35 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, five dental nurses, the decontamination assistant, four receptionists and the practice manager. We looked at practice policies and procedures, patient feedback and other records about how the service is managed.

The practice is open: Monday to Thursday from 9am to 6pm and Friday from 9am to 5pm.

Our key findings were:

• Effective leadership from the partnership and practice manager was evident.
• Staff had been trained to deal with emergencies. Appropriate medicines and most lifesaving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting of untoward incidents and shared learning when they occurred in the practice.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice was aware of the needs of the local population and took these into account when delivering the service.
• Patients had access to routine treatment and urgent care when required.
• Staff received training appropriate to their roles and were supported in their continuing professional development (CPD) by the practice.
• The practice had systems to address complaints and those received were investigated appropriately.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• Governance arrangements were embedded within the practice.

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

• Review staff training and equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK) and The Intercollegiate Advisory Committee on Sedation in Dentistry document 'Standards for Conscious Sedation in the Provision of Dental Care 2015.
• Review the practice policies and protocols in relation to domiciliary care taking into account the guidance provided by the British Society for Disability and Oral Health.
• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff. This refers particularly to staff immunity to Hepatitis B and ensure that any appropriate action is taken once received.