Mr David Power - Marske-by-the-Sea

We carried out this announced inspection on 29 October 2019 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

Mr David Power - Marske-by-the-Sea, known as Resi-Dent dental practice, is in Redcar and provides NHS dental treatment to adults. The provider is contracted to provide dental treatment in patient’s own homes, nursing and care homes (within domiciliary settings). The provider rents an office within a dental practice in Redcar, and there is an agreement with the dental practice to use their decontamination and clinical waste facilities.

The dental team includes the principal dentist, a dental nurse and a practice manager who also carries out reception duties.

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 23 CQC comment cards filled in by patients, their relatives and care home staff. These provided a highly positive view of the dental team, and of the care provided by staff.

During the inspection we spoke with the principal dentist, the dental nurse and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The service operates:

Monday to Thursday 8.30am to 4.30pm

Friday 8.30am to 2.30pm.

Our key findings were:

• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available, and carried on all domiciliary visits.
• The provider had systems to help them manage risk to patients and staff. The provider should review their fire risk assessment and fire safety measures.
• The provider had suitable safeguarding processes. Staff understood their responsibilities and were clear on referral protocols. The provider and practice manager had not received training of the appropriate level in the safeguarding of vulnerable adults.
• The provider had thorough staff recruitment procedures.
• The clinical staff provided domiciliary 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.
• Staff supported patients to ensure better oral health. Any treatment that was not within the scope of the domiciliary service was explained and the patient referred elsewhere.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Improve the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, undertake a risk assessment of domiciliary premises and of fire safety for the office.

• Take action to ensure that all the staff have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.