Archived: Irby Dental Surgery

We undertook a follow up focused inspection of Irby Dental Surgery on 8 August 2018. This inspection was carried out to review in detail the actions taken by the provider to improve the quality of care, and to confirm that the practice was now meeting the legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Irby Dental Surgery on 11 April 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the provider was not providing well-led care, and was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Irby Dental Surgery on our website www.cqc.org.uk.

When one or more of the five questions are not met we require the provider to make improvements. We then inspect again after a reasonable interval, focusing on the areas in which improvement was necessary.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made sufficient improvements in relation to the regulatory breach we identified at our inspection on 11 April 2018.

Background

Irby Dental Surgery is near the centre of Irby and provides private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and for those with pushchairs. Car parking spaces are available at the practice.

The dental team includes two dentists, two dental hygiene therapists and three dental nurses, one of whom is the practice manager. 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. The registered manager at Irby Dental Surgery is the principal dentist.

During the inspection we spoke with the principal dentist, a dental nurse, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 9.00am to 5.30pm.

Our key findings were:

• The provider had improved their systems and processes to enable them to assess, monitor and improve the quality and safety of the services being provided, for example, we saw infection control systems were now operating more effectively.

• We saw that the provider’s systems and processes for enabling them to identify and reduce risks at the practice were now operating more effectively, for example, in relation to the control of the practice’s water systems.

• The provider had improved systems and processes to enable them to evaluate and improve their practice and had put further arrangements in place to encourage patients to provide feedback.

• We found that the system for monitoring staff training had improved but was not operating effectively.

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

• Review the practice's protocols and procedures to ensure staff are up to date with their training and continuing professional development.

• Review the practice’s protocols to ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

We carried out this announced inspection on 11 April 2018 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 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 not providing well-led care in accordance with the relevant regulations.

Background

Irby Dental Surgery is near the centre of Irby and provides private dental care and treatment for patients of all ages.

There is level access to the practice for people who use wheelchairs and for those with pushchairs. Car parking spaces are available at the practice.

The dental team includes two dentists, two dental hygiene therapists and three dental nurses, one of whom is the practice manager. 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. The registered manager at Irby Dental Surgery was the principal dentist.

We received feedback from twelve people during the inspection about the services provided. The feedback provided was positive about the practice.

During the inspection we spoke to the two dentists, dental nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 9.00am to 5.30pm.

Our key findings were:

• The practice was clean and well maintained.
• Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available.
• The provider had staff recruitment procedures in place.
• 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 dental team provided preventive care and supported patients to achieve better oral health.
• The appointment system took account of patients’ needs.
• The practice had a leadership and management structure in place.
• Staff felt involved and supported.
• The provider had information governance arrangements in place.
• The practice had infection control procedures in place. These did not always reflect published guidance.
• The provider had systems in place to manage risk. We found that systems relating to the control of hazardous substances, staff vaccination and the control of Legionella were not operating effectively.
• The provider had safeguarding procedures in place and staff knew their responsibilities for safeguarding adults and children. We saw that the safeguarding procedures were not practice specific.
• We saw that the provider’s complaints procedure did not contain sufficient information.
• The provider had limited arrangements in place to seek the views of patients about the services they provided.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review the practice's policies and procedures for obtaining patient consent to care and treatment to ensure they are in compliance with legislation, take into account relevant guidance, and staff follow them.
• Review the practice's complaint handling procedures and establish an accessible system for identifying, receiving, recording, handling and responding to complaints by service users. This did not include information about the Dental Complaints Service.
• Review the practice’s protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.