Updated 5 December 2019
We carried out this announced inspection on 31 October 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 providing well-led care in accordance with the relevant regulations.
Background
Features Nottingham is on the edge of Nottingham city centre and provides private dental treatment to adults and children.
There is stepped access into the practice with both treatment rooms on the first floor. There are free car parking spaces available at the practice (at the rear of the premises) including spaces for blue badge holders and those with restricted mobility. Alternatively there are pay and display car parks near the practice.
The dental team includes two dentists, three dental nurses one of whom also has administrative and reception duties. The practice has two treatment rooms and an instrument decontamination room.
The practice is owned by an organisation 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 Features Nottingham is the principal dentist.
On the day of inspection, we collected 48 CQC comment cards filled in by patients. Comments from patients were wholly positive.
During the inspection we spoke with two dentists and three dental nurses. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday: 9am to 5.30pm, Tuesday: 9am to 5.30 pm, Wednesday: 9am to 5pm, Thursday: 9am to 5.30pm and Friday 9am to 1pm.
Our key findings were:
- The practice appeared clean and well maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- Improvements could be made when antibiotics are dispensed from the practice to ensure packaging is labelled in accordance with Human Medicines Regulations 2012.
- The provider had systems to help them manage risk to patients and staff.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had thorough staff recruitment procedures.
- 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.
- Improvements could be made to the practice consent policy to ensure both Gillick and best interest decisions are identified and explained.
- Staff provided preventive care and supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and culture of continuous improvement.
- Staff felt involved and supported and worked well as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- Improvements could be made to the practice’s systems for completing audits.
- The provider had suitable information governance arrangements.
There were areas where the provider could make improvements. They should:
- Review the practice protocols regarding audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice. Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Human Medicines Regulations 2012.
- Improve and develop staff awareness of Gillick competency and ensure all staff are aware of their responsibilities in relation to this.
- Take action to ensure audits of radiography and infection prevention and control are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.