Bellstone Dental Practice

We undertook a focused inspection of Bellstone Dental Practice on 26 February 2020. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported remotely by a specialist dental adviser.

We undertook a comprehensive inspection of Bellstone Dental Practice on 25 June 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well-led care and was in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Bellstone Dental Practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

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

The provider had made improvements in relation to the regulatory breach we found at our inspection on 25 June 2019.

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Background

Bellstone Dental Practice is in Shrewsbury, Shropshire and provides NHS and private treatment for adults and children. The practice is one of two within Shropshire registered under the same provider.

Bellstone Dental Practice is in the town centre. There is no dedicated parking due to the location of the practice. The practice is accessible via public transport with a bus stop within 200 metres. This bus stop is also utilised by the local park and ride service. Access into the reception area is up two small steps. There is no access for wheelchair users.

The dental team includes four dentists, a dental hygienist, four dental nurses including three trainee dental nurses and a practice manager. The practice has three treatment rooms and centralised decontamination facilities.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission 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 Bellstone Dental Practice is the principal dentist.

During the inspection we spoke with the principal dentist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday: from 9am to 5pm.

Our key findings were:

• Staff training records had been updated and a system developed to give oversight of staff training and continuous professional development.
• The emergency medicines had been reviewed. The practice now held all of the medicines required, as described in national guidance.
• Staff recruitment records had been audited and the practice had all of the records required by the regulations for each member of staff.
• The system for monitoring complaints has been reviewed and records were being kept. A system to analyse complaints had been introduced.
• Radiography audits had been completed for each dentist, all within the last year.
• The system for untoward incidents/ significant events has been reviewed and this now captured all of the information and provided analysis and shared learning.

We carried out this announced inspection on 25 June 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 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 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 not providing well-led care in accordance with the relevant regulations.

Background

Bellstone Dental Practice is located in Shrewsbury, Shropshire and provides NHS and private treatment to adults and children. The practice is one of two within Shropshire registered under the same provider.

Bellstone Dental Practice is in the town centre. There is no dedicated parking due to the location of the practice. The practice is easily accessible via public transport with a bus stop within 200m. This bus stop is also utilised by the local park and ride service. Access into the reception area is up two small steps. There is no access for wheelchair users.

The dental team includes four dentists including the registered manager, two dental nurses, three trainee dental nurses, one dental hygienist, one practice administrator and one practice manager. The practice manager predominantly works from the other practice. The practice has three treatment rooms. Due to the age of the building, the practice has limited scope for alterations of the treatment room locations. One treatment room is on the ground floor and down two small steps. The two other treatment rooms are on the first floor, accessible via stairs with a railing.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission 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 Bellstone Dental Practice is the principal dentist.

On the day of inspection, we collected 36 CQC comment cards filled in by patients and spoke with one other patient.

During the inspection we spoke with two dentists including the registered manager, one dental nurse, the practice administrator and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 9am to 5pm.

The practice is closed on Saturdays and Sundays.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• The infection control lead did not have up to date training. We received evidence of completed training after the inspection..
• 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.
• We saw evidence of only two staff members having completed safeguarding training to the required level. We received evidence after the inspection that all staff had completed training to the required level.
• The provider had staff recruitment procedures. We saw evidence these had not been adhered to and required improvement. The recruitment policy was updated after inspection.
• 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 supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• We did not see evidence of how complaints had been dealt with.
• The provider had information governance arrangements which required improvements.

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

Full details of the regulations the provider was not meeting are at the end of this report.

We identified regulations the provider was not complying with. They should:

• Review the practice's processes and systems for seeking and learning from patient feedback with a view to monitoring and improving the quality of the service.

• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.