One Two Three Dental

Updated 5 May 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 registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection took place on the 6 February 2017 and was led by 2 CQC inspectors.

Prior to the inspection we asked the practice to provide us with information which we reviewed. This included their latest statement of purpose, and staff details, including their qualifications and professional body registration number where appropriate. We also reviewed information we held about the practice.

During the inspection we spoke with two dentists, two dental nurses and reception staff. We toured the practice and reviewed emergency medicines and equipment.

We reviewed policies, protocols and other documents and observed procedures. We sent comment cards to the practice but unfortunately these arrived only a few days before the visit. There were 22 comment cards completed by patients. We also reviewed the practice’s own satisfaction survey and these confirmed the overall patients were happy with the 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 5 May 2017

We carried out an announced comprehensive inspection on 6 February 2017 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

Bickerton Dental Practice Limited offers a full range of dental treatments including preventative, corrective and cosmetic treatments. The practice is based in the centre of Guiseley, West Yorkshire, close to the main shops. The staff consists of five dentists, a dental hygienist, nine dental nurses (two of whom are also receptionists).

The practice is in a purpose built building. There are three treatment rooms, a decontamination room, an office/ staff area and a waiting/ reception room. Public parking is available near the practice. The opening hours are Monday/Wednesday/Thursday 8am-5:30pm Tuesday 8am-6:30pm and Friday 9am-5pm.

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 was the principal dentist.

Our key findings were:

• The premises were visibly clean and tidy.
• The practice had procedures in place to record and analyse significant events and incidents.
• Staff had received safeguarding training, and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified, skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, but some emergency equipment was out of date.
• A Legionella risk assessment was in place but regular monitoring and recording of water temperatures was not completed.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• The practice had policies, procedures to help them manage the service but some risk assessments needed review.
• The practice had governance arrangements in place but had omitted some areas in monitoring and assessing the quality and safety of the services provided.

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

• Review the recommendation of water temperature testing from the current legionella risk assessment is implemented, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review systems to ensure all risk assessments are up to date and all safety certificates are in place.
• Review governance arrangements to take into account the full range of management and administrative tasks including the practice’s policies procedures and risk assessments.
• Review the equipment used for medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice’s protocols for medicines management and ensure prescriptions pads and items are stored safely and securely.
• Review the storage of dental care records to ensure they are stored securely.
• Review the domestic cleaning equipment is in line with the recommended guidelines.
• Review access and signage to the decontamination and X-ray area.
• Review the practice's recruitment policy is adhered to and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff.