Archived: Devon Teeth Straightening Clinic

We carried out an announced comprehensive inspection on 6 March 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

Devon Teeth Straightening Clinic is located in the centre of the city of Exeter, Devon. It is situated on the ground floor with two treatment rooms, a patient waiting area/reception and has a purpose built decontamination room for the cleaning and sterilising of dental instruments. There is nearby parking in city centre car parks. The practice provides general dental services, dental hygiene, cosmetic teeth straightening and teeth whitening systems under private patient care. Approximately 1,650 patients are registered at the practice.

The staff structure of the practice consists of a group director/dentist, practice manager/dental nurse/receptionist, dentist, dental hygienist and two dental nurses.

The practice is open from Monday to Friday 10am – 6pm, with some occasional Saturday opening by appointment/patient request. There is an answer phone message directing patients to emergency contact numbers when the practice is closed.

The group director is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons 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 inspection took place over one day and was carried out by a CQC inspector, who had access to remote advice from a specialist advisor.

Twenty eight patients provided feedback directly to CQC about the service. All were positive about the care they received from the practice. They were complimentary about the friendly, professional and caring attitude of the dental staff and the dental treatment they had received.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• There were effective systems in place to reduce and minimise the risk and spread of infection.
• There was a lead staff member for safeguarding patients. All staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from the practice team.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients could access treatment and urgent and emergency care when required.
• Patients could book appointments up to 12 months in advance.
• Appointment text/phone reminders were available on request 48 hours prior to appointments.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Staff had been trained to handle emergencies and appropriate medicines were readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Staff received training appropriate to their roles and were supported in their continued professional development by the management team.
• Staff we spoke with felt supported by the management team and were committed to providing a quality service to their patients.

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

• Review the practice’s infection control procedures and protocols taking into acount 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 availability of equipment such as an automated external defibrillator (AED) to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team. The provider must ensure a risk assessment is undertaken if a decision is made to not have an AED on-site.
• Review the arrangements for the sterile storage of local anaesthetic cartridges.
• Review the practice’s audit protocols to ensure that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.