Background to this inspection
Updated
14 October 2016
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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
This inspection took place on 16 August 2016 and was led by a CQC inspector and supported by a specialist dental advisor. Prior to the inspection, we reviewed information we held about the provider. We asked the practice to send us some information that we reviewed. This included the complaints they had received in the last 12 months, their latest statement of purpose, and the details of their staff members including proof of registration with their professional bodies.
During our inspection we toured the premises; we reviewed policy documents and staff recruitment records and spoke with four members of staff, including the registered manager. We looked at the storage arrangements for emergency medicines and equipment. We were shown the decontamination procedures for dental instruments and the computer system that supported the dental care records.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
These questions therefore formed the framework for the areas we looked at during the inspection.
Updated
14 October 2016
We carried out an announced comprehensive inspection on 16 August 2016 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
Smilestylist House of Fraser Birmingham Dental Practice has two dentists who work part time, one qualified dental nurse who is registered with the General Dental Council (GDC) a practice manager and a receptionist. The practice’s opening hours are 9.30am to 6pm on Monday, Tuesday, Wednesday and Friday, and 10.30am to 7pm Thursday. The practice is also open every Saturday from 9am to 5.30pm. The practice is closed for 30 minutes each day between 2.30pm to 3pm.
Smilestylist Dental Practice provides private dental treatment for adults and children. The practice is located within the House of Fraser department store. There are a few small steps within the store to gain access to the dental practice. There are two dental treatment rooms one of which is used for the specific purpose of tooth whitening. There is a separate decontamination room for cleaning, sterilising and packing dental instruments and a consultation room. There is also a reception and waiting area.
The registered manager was present during this inspection. 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.
Before the inspection we sent Care Quality Commission comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received feedback from seven patients who provided an overwhelmingly positive view of the services the practice provides. All of the patients commented that the quality of care was very good and that staff were friendly and helpful.
Our key findings were
- Systems were in place for the recording and learning from significant events and accidents.
- There were sufficient numbers of suitably qualified staff to meet the needs of patients.
- Patients were treated with dignity and respect.
- The practice was visibly clean and well maintained.
- Infection control procedures were in place with infection prevention and control audits being undertaken on a six monthly basis. Staff had access to personal protective equipment such as gloves and aprons.
- There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
- The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice. Systems were in place to check these to ensure that they were within their expiry dates; however checks were not completed regularly as recommended by national guidance.
- Staff had been trained to deal with medical emergencies.
- The practice was well-led and staff felt involved and worked as a team.
There were areas where the provider could make improvements and should:
- Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
- Review the timescales for the checking and documentation of checks regarding medicines to manage medical emergencies giving due regarding to the guidelines issued by the Resuscitation Council (UK).
- Review systems in place for the recording of medicines dispensed at the practice to ensure documentation kept is signed by the prescriber.
- Review the systems in place for scheduling of appointment times to ensure that patients are given times of appropriate length for the treatment to be completed.
- Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
- Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
- Review the practice’s audit protocols of various aspects of the service, such as radiography and dental care records to help improve the quality of service. Review its audit protocols to document learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.