Updated 20 December 2019
We carried out this announced inspection on 15 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
High Locks Dental Practice is in Deeping St James, a large village in the South Kesteven district of Lincolnshire. It provides NHS dental care for children only and private treatment for adults.
There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available in the practice’s car park and on the street in front of the premises.
The dental team includes five dentists, one implantologist, five dental nurses (including two trainee nurses), two dental hygienists, two receptionists and a practice manager. The practice has four treatment rooms and a separate decontamination room, all on ground floor level.
The practice is owned by a company and as a condition of registration must have a person registered with the CQC 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 High Locks Dental Practice is the principal dentist.
We sent 50 comment cards in advance of our visit to the practice for patients to complete. On the day of inspection, we collected 25 CQC comment cards that had been filled in by patients. This represented a 50% response rate.
During the inspection we spoke with two dentists, one trainee dental nurse, one dental hygienist, the head receptionist and the practice manager. We looked at practice policies and procedures, patient feedback and other records about how the service is managed.
The practice is open: Monday from 8am to 7.30pm, Tuesday, Wednesday from 8am to 5.30pm, Thursday and Friday from 8am to 4.30pm.
Our key findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and some life-saving equipment were available with some exceptions. Items required were obtained by the practice straight after our inspection.
- The provider had systems to help them manage most risks to patients and staff. We noted a lone worker risk assessment was not in place for when hygienists worked without chairside support. This was undertaken after the day of our visit.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which mostly reflected current legislation. We noted that references had not always been sought for new staff; we were told that these staff were already known to the provider prior to their recruitment.
- The clinical 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.
- 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 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:
- Ensure there are systems in place to track and monitor NHS prescription pad use.
- Review guidance regarding basic periodontal examination (BPE) from the British Society of Periodontology.
- Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.