Archived: Nottingham Emergency Dental Services Limited

Updated 25 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We carried out an announced, comprehensive inspection on 19 October 2016. The inspection team consisted of a Care Quality Commission (CQC) inspector and a dental specialist advisor.

Before the inspection we asked for information to be sent, this included the complaints the practice had received in the last 12 months; their latest statement of purpose; the details of the staff members, their qualifications and proof of registration with their professional bodies.

We reviewed the information we held about the service and found there were no areas of concern.

We reviewed policies, procedures and other documents. We received feedback from 17 patients about the dental service.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 25 January 2017

We carried out an announced comprehensive inspection on 15 November 2016 to ask the service 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 providing well-led care in accordance with the relevant regulations.

Background

The service is located on the ground floor of premises to the west of the city centre close to the Queens Medical Centre (QMC). The service provides a mixture of NHS and private out-of-hours emergency dental treatments and a minor oral surgery service (IMOS). There is a small car park located at the service. There are two treatment rooms all of which are located on the ground floor.

The service provides out-of-hours regulated emergency dental services to both adults and children. Services provided include emergency general dentistry, Planned minor oral surgery up to three times a week.

The service’s opening hours are – Monday to Friday: 7 pm to 9:15 pm with access through referral from the NHS 111; Saturday: 2 pm to 5 pm and 6 pm to 9 pm; Sunday: 9 am to 12 noon, 2 pm to 5 pm and 6 pm to 9pm. In addition the service has a contract for minor oral surgery with NHS referrals from dentists on Tuesday and Wednesday: 9:30 am to 2:30 pm and Saturday: 8:30 am to 1 pm.

The clinical director who is a dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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.

The practice has 13 dentists and 23 qualified dental nurses; Dental nurses also worked on the reception desk.

Before the inspection we sent Care Quality Commission comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received feedback from 17 patients who provided a positive view of the services the practice provides. All of the patients provided positive feedback.

Our key findings were:

• The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Patients commented they had no problem getting an appointment that suited their needs.
• Patients were able to access emergency treatment when they were in pain.
• Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect; and the dentist involved them in discussions about treatment options and answered questions.
• Patients’ confidentiality was protected.
• There were systems to record accidents, significant events and complaints, and where learning points were identified these were shared with staff.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns.
• Where audits identified improvements were needed these had not always been followed through.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.

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

• Review the service’s audit protocols of various aspects of the service, such as dental care records at regular intervals to help improve the quality of service. The service should also check all audits have documented learning points and the resulting improvements can be demonstrated.