Rotherham Road Dental Practice

We carried out an announced comprehensive inspection on 22 November 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 not 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

Rotherham Road Dental Practice is a general dental practice is the Holbrooks area of Coventry. It is also known as Holbrook Dental Surgery.

The practice provides general dental treatment to adults and children funded mostly by the NHS, or privately.

The practice is open from 9 am until 5.30 pm on Monday, Tuesday, Thursday and Friday. From 9 am until 8 pm on Wednesday and from 9 am until 1 pm on Saturday.

The practice is staffed by a principal dentist supported by a qualified dental nurse, a trainee dental nurse and a receptionist.

The practice offers domiciliary visits for patients who are unable to attend the practice.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

We received comments from 24 patients about the service by way of comment cards available at the practice for two weeks prior to the inspection.

Our key findings were:

• The practice was visibly clean and clutter free.

• The practice was taking on NHS patients at the time of the inspection and patients could expect to be offered an appointment within a few days.

• The practice met the national guidance in infection control measures; however they were not auditing the process to highlight any areas of improvement.

• The practice offered evening appointments on one day a week and appointments on a Saturday morning to allow flexibility for patients who had commitments during normal working hours.

• The practice carried medicines for use in a medical emergency, however certain pieces of the emergency equipment were out of date and the practice did not have an automated external defibrillator.

• Emergency medicines and equipment was not taken on domiciliary visits.

• Pertaining to the safe use of X-rays on the premises: documentation had not been recently updated. The practice were not always recording a written justification, quality grade and report of findings of all X-rays taken. X-ray quality was not audited to highlight areas for improvement.

• The practice did not have a policy regarding safeguarding vulnerable adults, and staff had not received training in this area.

• Risk assessments regarding the health and safety of staff, visitors and patients to the practice had not been completed; therefore the risks had not been adequately assessed or mitigated.

• Certain equipment had not been serviced or validated in line with manufacturers’ guidance; for example the ultrasonic cleaner and X–ray machines.

• The practice did not have a process in place to manage significant incidents.

• A legionella risk assessment had been completed a few days prior to the inspection however the report had not been received by the practice and therefore appropriate checks and actions had not been commenced at the time of the inspection.

We identified regulations that were not being met and the provider must:

• Ensure that effective systems and processes are in place and are operated effectively to ensure compliance with the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. For example; management of significant incidents, having appropriate and relevant policy available for staff to reference, use of clinical audit to highlight areas for improvement, systems in place to recognise the servicing and validation needs of equipment and training needs of staff pertaining to safeguarding, the Mental Capacity Act and Gillick competence.

• Ensure that care and treatment is provided in a safe way against the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. For example; availability of appropriate medicines and equipment for use in a medical emergency within the practice and on domiciliary visits and management of risk.

You can see full details of the regulations not being met at the end of this report.

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

• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

• Review the availability of an interpreter service for patients who do not speak English as their first language, and review the provision of a hearing loop to assist patients that used hearing aids.

• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and comprehensive.

• Review the practice protocols regarding records of prescription forms with reference to the NHS guidance on security of prescription forms August 2013.

• Review national guidelines in the care and treatment of patients.