Cromwell Dental Practice

Updated 4 April 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 over one day and was carried out by a CQC inspector and a dental specialist advisor.

During our inspection visit, we reviewed policy documents and staff training and recruitment records. We spoke to all five members of staff, conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. We were shown the decontamination procedures for dental instruments and the systems that supported the patient dental care records.

We reviewed 19 Care Quality Commission (CQC) comment cards that had been completed by patients in the two weeks prior to our inspection. All the comments were positive.

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 4 April 2017

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

Cromwell Dental Practice operates from a converted commercial property and provides a mix of private and NHS dentistry. The practice is situated in the town Walton On Thames, Surrey. The practice has two dental treatment rooms; decontamination of dental instruments is mainly carried out within a designated area of each treatment room with another autoclave housed in a designated space in the kitchen area.

The practice staff consists of a dentist, a receptionist and a dental nurse. The practice also employs two part-time dental hygienists.

The practice opens:

Monday to Friday between 9.00am and 5.30pm.

The practice owner 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 and a dental specialist advisor.

Before the inspection we sent Care Quality Commission (CQC) comments cards to the practice for patients to complete to tell us about their experience of the practice. We collected 19 completed cards. All the comments from patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• 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 systems in place to reduce and minimise the risk and spread of infection. We did note there were areas that could be improved; these are detailed in the main body of the report.
• The practice had safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• There was a system in place for reporting incidents.
• 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 a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice maintained a clinical governance system to underpin the clinical care provided.

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

• Review the practice’s risk assessments and ensure sharps handling procedures and protocols are in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Consider providing an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance is prepared.

• Consider providing the hygienist with the support of an appropriately trained member of the dental team.
• Review the availability of hearing loops for patients who are hard of hearing.
• Consider implementing a system to account for NHS prescriptions issued by the dentist to prevent inappropriate prescribing or loss of prescriptions.
• Review the practice's protocols for completion of dental records taking into account the guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.