Updated 25 July 2017
We carried out this announced inspection on 5 June 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection in response to concerns raised to the CQC in order 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
Walnut Dental Centre is in Milton Keynes and provides private treatment to patients of all ages.
There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including some for patients with disabled badges, are available near the practice.
Two dentists work at the practice and are supported by a pool of eight dental nurses and five receptionists, who work across all five practices owned by the company. The practice has two treatment rooms.
The practice is owned by a company 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 the inspection the practice did not have a registered manager in post. After the inspection we were told by the owner of the practice that an application to register a manager was to be submitted.
On the day of inspection we collected 25 CQC comment cards filled in by patients and spoke with two patients. This information gave us a positive view of the practice.
During the inspection we spoke with one dentist, one dental nurse, one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open from Monday to Friday between 8:30am and 5:30pm.
Our key findings were:
- The practice was clean and well maintained.
- The practice had infection control procedures which reflected published guidance. We identified some necessary improvements.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available; however, some were missing or had expired.
- The practice had systems to help them manage risk.
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
- The practice had staff recruitment procedures; however, information was missing about the immunisation for two staff members.
- 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.
- The practice had effective leadership. Staff felt involved and supported and worked well as a team.
- The practice asked staff and patients for feedback about the services they provided.
- The practice dealt with complaints positively and efficiently.
There were areas where the provider could make improvements. They should:
- Review availability of medicines and equipment to manage medical emergencies taking into account guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team. Staff should carry out thorough checks to ensure that expired medicines and materials are disposed of in a timely manner.
- Review availability of an interpreter services for patients who do not speak English as a first language.
- Review the protocol for completing accurate, complete and detailed records relating to the recruitment of staff. This includes ensuring recruitment checks, including evidence of immunisation status, are suitably obtained and recorded.
- Review the risk assessment for Legionella prevention and ensure that all recommendations are followed.
- Review the formal report made by the radiation protection advisor and ensure that all recommendations are completed.