Carholme Dental Practice

We carried out this announced inspection on 13 June 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

Carholme Dental Practice is in the centre of Lincoln. The practice provides both NHS and private dental treatment to adults and children.

There is level access through the front door, and room for blue badge holders to park at the practice. The practice has five treatment rooms, two are located on the ground floor.

The dental team includes nine dentists, one dental hygienist, two dental therapists, ten dental nurses, including three trainee dental nurses, three receptionists and a practice manager.

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. The registered manager at Carholme Dental Practice is the practice manager.

On the day of inspection, we collected 41 CQC comment cards filled in by patients and spoke with two others in the practice.

During the inspection we spoke with three dentists and four dental nurses including the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday: from 8am to 6pm, Tuesday: from 8am to 8pm, Wednesday: from 8am to 6pm, Thursday: from 8am to 6pm, Friday: from 8am to 4pm and Saturday: from 9am to 2pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• The decontamination room was not ventilated.
• A regular audit of dental instruments would identify when they are damaged and in need of replacement.
• Under the act. Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had the staff recruitment information required by the Regulations.
• 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• When antibiotics were dispensed, the labelling did not always contain all the information required by regulations.
• 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.
• There was room for improvement in relation to staff awareness of the Mental Capacity Act (2005) and their responsibilities
• The provider had suitable information governance arrangements.

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

• Review the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular review the ventilation in the decontamination room.

• Review staff awareness of the requirements of the Mental Capacity Act 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

• Review the practice’s protocols to ensure audits of dental instruments are undertaken at regular intervals to ensure that dental instruments are not damaged and are fit for purpose.

• Review the practice's protocols for medicines management and ensure all medicines are dispensed safely and securely.