Talking Teeth Dental Practice - Widnes

We carried out this unannounced inspection on 26 November 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 Care Quality Commission, (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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

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

Background

Talking teeth is in Widnes, Cheshire and provides NHS and private dental care and treatment for adults and children.

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

The dental team includes seven dentists, six dental nurses, one dental hygiene therapists and two receptionists. The principal dentist and area manager were present during the inspection. The practice has five treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

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

The practice is open: Monday to Thursday 8:30am to 5pm and Friday 8:30am to 4:15pm.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• Improvements could be made to ensure the practice’s infection control procedures fully reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The provider had systems to help them manage risk to patients and staff. Risk mitigation for sharps use and manual instrument cleaning were not embedded.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff responsibilities in respect to the Mental Capacity Act 2005 and Power of Attorney could be improved.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Oversight of current systems could be improved for staff in training to ensure guidance and regulations are being followed.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements.

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

• Improve the practice’s infection control procedures and related audit process taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance. In particular: Risk mitigation and staff awareness of manual cleaning process, equipment validation and use of instrument pouches.
• Improve the practice’s sharps procedures to ensure the practice follows the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017. In particular: Update local rules to reflect the system used to secure the second entrance into treatment room number two.
• Improve and develop staff awareness of the requirements and responsibilities relating to the Mental Capacity Act 2005, guardianship and Power of Attorney.

• Review the practice’s systems to ensure oversight of processes for staff in training is effective.