Exchange Street Practice Ltd

Updated 24 March 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 registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection was carried out on 25 February 2016 and was led by a CQC Inspector and a dental specialist advisor.

We informed the NHS England area team and Healthwatch that we were inspecting the practice; however we did not receive any information of concern from them.

The methods we used to collect information at the inspection included interviewing staff, observations and reviewing documents.

During the inspection we spoke with two dentists, two dental nurses, and the practice manager. We received feedback forms from seven other members of staff and saw policies, procedures and other records relating to the management of the service. We reviewed two CQC comment cards that had been completed.

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 24 March 2016

We carried out an announced comprehensive inspection on 25 February 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

Exchange Street dental practice provides general dental treatment to NHS patients including preventative advice and routine restorative dental care. The practice is located near the town centre of Driffield, East Riding of Yorkshire with nearby on street parking.

There are a series of narrow staircases which patients have to climb to access the dental service. Therefore, this service may not be suitable for patients with mobility problems. It has two principal dentists, an associate dentist a foundation training dentist, a dental hygienist, a dental hygiene therapist, seven dental nurses (two of which are trainees), a receptionist and a practice manager.

The practice has five dental surgeries; two are located on the second floor of the practice and the other three on the first floor. There is a reception area, a waiting room, patient toilets and staff changing room and toilets, an office and a decontamination room.

One of the practice principles is 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 opening times are:

Monday – Friday 09:00 – 12:30 & 13:30 – 17:00.

On the day of inspection we received two CQC comment cards providing feedback and spoke to three patients. The patients who provided feedback were very positive about the care and attention they received at the practice. They told us they were involved in all aspects of their care and found the staff to be kind, helpful and professional and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to manage medical emergencies.
• Infection control procedures were in accordance with the published guidelines.
• Patient care and treatment was planned and delivered in line with evidence based guidelines, best practice and current regulations.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• There was a complaints system in place. Staff recorded complaints and cascaded learning to staff.
• The governance systems were effective.
• Staff demonstrated knowledge about whistleblowing and were confident they would raise a concern about another staff member’s performance if it was necessary.

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

• Implement yearly patient satisfaction surveys to allow patients the opportunity to feedback and views or comments to the practice.
• Implement a practice protocol for sharing alerts from the Medicines and Healthcare products Regulatory Agency (MHRA), the UK’s regulator of medicines, medical devices and blood components for transfusion, responsible for ensuring their safety, quality and effectiveness.
• Review the practice's recruitment policy and procedures so they are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.
• Review the practice’s process for the auditing of various aspects of the service, such as patient dental care records and X-rays so they are undertaken at regular intervals to help improve the quality of service. The practice should also ensure all audits have documented learning points so the resulting improvements can be demonstrated.