Background to this inspection
Updated
9 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.
This inspection took place on 10 October 2016 and was led by a CQC inspector and supported by a specialist dental advisor. Prior to the inspection, we reviewed information we held about the provider. We informed NHS England area team that we were inspecting the practice and we did not receive any information of concern from them. We asked the practice to send us some information that we reviewed. This included the complaints they had received in the last 12 months, their latest statement of purpose, and the details of their staff members including proof of registration with their professional bodies.
During our inspection we toured the premises; we reviewed policy documents and staff records and spoke with three members of staff. We looked at the storage arrangements for emergency medicines and equipment. We were shown the decontamination procedures for dental instruments and the computer system that supported the dental care records.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
These questions therefore formed the framework for the areas we looked at during the inspection.
Updated
9 January 2017
We carried out an announced comprehensive inspection on 10 October 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 providing well-led care in accordance with the relevant regulations.
Background
St James Dental Centre has one dentist who works part time, a part time dental hygienist, three qualified dental nurses who are registered with the General Dental Council (GDC), a practice manager and a receptionist. The practice’s opening hours are 8.30am to 6pm on Monday 8.30am to 1pm on Wednesday and 8.30am to 5.30pm on Friday.
St James Dental Centre provides private dental treatment for adults and children. The practice has two dental treatment rooms on the ground floor. Sterilisation and packing of dental instruments takes place in the treatment room. There is a reception with separate waiting area.
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. During the inspection we spoke with three patients. Overall we received feedback from 35 patients who provided an overwhelmingly positive view of the services the practice provides. All of the patients commented that the quality of care was very good and staff were friendly and caring.
Our key findings were
- Systems were in place for the recording and learning from significant events and accidents.
- There were sufficient numbers of suitably qualified staff to meet the needs of patients.
- Patients were treated with dignity and respect.
- The practice was visibly clean and well maintained.
- Infection control procedures were in place with infection prevention and control audits being undertaken on a six monthly basis. Staff had access to personal protective equipment such as gloves and aprons.
- There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
- Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
- The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice. Staff had been trained to deal with medical emergencies.
- The appointment system met the needs of patients and waiting times were kept to a minimum.
- The governance systems were effective.
- The practice was well-led and there were clearly defined leadership roles within the practice. Staff told us they felt supported, involved and they all worked as a team.
There were areas where the provider could make improvements and should
- Review the practice’s RIDDOR policy to ensure correct information regarding reporting information under RIDDOR regulations is recorded.
- Review the practice’s procedures regarding medicines and equipment to be used in a medical emergency to ensure that the frequency of checks completed is in line with the Resuscitation Council (UK) guidance.
- Review the systems in place for managing first aid and provide evidence that those staff identified as the designated first aider has completed relevant training.
- Review the practice's protocols for completion of dental records and ensure that the dental hygienist gives due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
- Review the systems in place to ensure firefighting equipment at the practice is serviced, maintained and checked on a regular basis.