Total Dentalcare Cathedral Square

Updated 25 February 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 practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008

The inspection took place on 26 January 2016 and was conducted by a CQC inspector and a dental specialist advisor.

During the inspection we spoke with three dentists, the practice manager, two dental nurses and an hygienist. We received feedback from surveys completed by 10 patients about the quality of the service. We observed one patient consultation, reviewed policies, procedures and other documents relating to the management of the 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 25 February 2016

We carried out an announced comprehensive inspection on 26 January 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

Total Dentalcare Cathedral Square provides private dental treatment to children and adults and had about 1800 active patients at the time of our inspection. In addition to general dentistry, the practice also provides a full range of cosmetic procedures such as porcelain crowns, bridges, orthodontics, tooth whitening and implants.

The practice employs four dentists, two hygienists and has visiting periodontist and orthodontist specialists. They are supported by four dental nurses, a receptionist and a practice manager. It opens Monday, Tuesday, Wednesday and Fridays from 8.30am to 5.30 pm; and from 8.30am to 6pm on a Thursday.

The practice manager 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 practice is based on the third floor and shares its premises with other businesses. It has four treatment rooms, a decontamination room for cleaning, sterilising and packing dental instruments, a radiation room and a large staff room.

We received feedback from 10 patients about the service who told us that appointments were easy to book, that treatment options were explained well to them well, and that staff treated them in a way that they liked.

Our key findings were:

• The practice had systems to help ensure patient safety. These included safeguarding children and adults from abuse, responding to medical emergencies and maintaining equipment.

• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation

• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were actively involved in making decisions about it.

• Staff received training appropriate to their roles and told us they felt well supported to carry out their work.

• The practice sought feedback from staff and patients and used it to improve the service provided.

• Patients were treated in a way that they liked and information about them was treated confidentially.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Governance systems were effective and there was a range of audits and patient surveys to monitor the quality of services

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

• Regularly monitor the temperature of the fridge in which medicines are kept.

• Implement a system to ensure that MHRA alerts are disseminated to dental clinicians if relevant

• Review the practice’s infection control procedures and protocols giving due regard to 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
• Provide boxes in treatment rooms so that sharps can be disposed of safely.
• Ensure that staff are aware of the Department of Health’s publication Delivering Better Oral Health- an evidence based toolkit to support dental practices in improving their patients’ oral and general health.

• Close treatment room doors whilst care is being delivered to patients to maintain their privacy and confidentiality

• Provide all staff with regular appraisal of their performance.