Archived: Kedleston Dental Care

Updated 12 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.

We carried out an announced, comprehensive inspection on 9 February 2017. The inspection team consisted of a Care Quality Commission (CQC) inspector and a dental specialist advisor.

Before the inspection we asked for information to be sent, this included the complaints the practice had received in the last 12 months; their latest statement of purpose; the details of the staff members, their qualifications and proof of registration with their professional bodies.

We reviewed the information we held about the practice and found there were no concerns.

We reviewed policies, procedures and other documents. We received feedback from 33 patients about the dental service.

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 12 April 2017

We carried out an announced comprehensive inspection on 9 February 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

Kedleston Dental Care is located in premises situated to the north west of Derby city centre. There are four treatment rooms two of which are situated on the ground floor. The practice provides mostly private dental treatments (98%). There is a street parking for cars within the area and the practice is situated on a bus route with a bus stop outside the practice.

The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are – Monday: 9 am to 5:30 pm and Tuesday to Friday: 9 am to 5 pm. to 2 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients can telephone the NHS 111 telephone number. An NHS out-of-hours dentistry service also operates in Derby through the 111 telephone number. An emergency rota for dental practices in Derby operates 9 am to 5 pm to cover training, holidays and sickness. This is in the process of being expanded into a 24 hour 7 day service.

The practice manager is registered with the Care Quality Commission (CQC) as 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 practice is registered with the CQC as a partnership.

The practice has five dentists; two hygienists; four qualified dental nurses; one trainee dental nurse; one receptionist; and one practice manager.

Before the inspection we sent CQC 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 responses from 33 patients through both comment cards and by speaking with them during the inspection. Those patients provided positive feedback about the services the practice provides. Among the themes we identified from patient feedback were that the reception staff were friendly, confidentiality was respected, appointments were convenient, dentists were caring and explained what was happening and the options for treatment and that the premises were clean and well equipped. Several patients said they had been coming to the practice for many years and were very satisfied.

Our key findings were:

• The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
• The systems to record accidents, significant events and complaints, learning points from these were recorded and used to make improvements.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• There were effective systems at the practice related to the Control of Substance Hazardous to Health (COSHH) Regulations 2002.
• The practice had a consent policy including reference to the Mental Capacity Act 2005.
• Patients said they had no problem getting an appointment that suited their needs.
• Patients were able to access emergency treatment when they were in pain.
• Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect.
• There was limited oral health promotion information for patients in the waiting rooms.
• Dental care records demonstrated that the dentists involved patients in discussions about treatment options.
• Patients’ confidentiality was protected within the practice and steps had been taken to improve security.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments. However, an issue with one of the ultrasonic cleaners was highlighted during the inspection. The practice moved swiftly to address the issue.
• Flooring within the clinical areas was not as recommended by the guidance. Following the inspection we were informed arrangements had been to replace the flooring within an acceptably short time frame.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns about a colleague’s practice.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.

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

Review the number and range of health promotion information leaflets and posters available for patients.