We carried out an announced comprehensive inspection on 4 July 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 not providing well-led care in accordance with the relevant regulations.
Background
Diplomat Dental Care is a dental practice providing NHS and private treatment for both adults and children. The practice is situated in Blandford Forum, a town in Dorset.
The practice has five dental treatment rooms in use and a separate decontamination room used for cleaning, sterilising and packing dental instruments.
The practice is based in an adapted domestic dwelling.
The practice employs three dentists, one hygienist, six dental nurses of which four are trainees and a practice manager.
The practice’s opening hours are between 8am and 5pm on Monday, Wednesday and Thursday, 9am and 5.30pm on Tuesday, between 8am and 4.30pm on Friday and 8.30am and 12.30pm on Saturday.
There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service.
There was no registered manager at the time of our inspection at this location. We were told that the current Practice Manager was going through the CQC registration process to become 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.
We obtained the views of nine patients on the day of our inspection.
Our key findings were:
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We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
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Leadership was provided by an empowered practice manager.
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Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
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The practice appeared clean and well maintained.
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There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
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Infection control procedures were robust and the practice followed published guidance.
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The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
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There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
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Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
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The service was aware of the needs of the local population and took these into account in how the practice was run.
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Patients could access treatment and urgent and emergency care when required.
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Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the company.
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Staff we spoke with felt well supported by the practice manager and were committed to providing a quality service to their patients.
We identified regulations that were not being met and the provider must:
- Ensure the practice recruitment policy and procedures 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.
There were areas where the provider could make improvements and should:
- Review the availability of a hearing loop for patients who are hearing aid users.
- 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.
- Review the practice’s infection control procedures and protocols taking into account 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 practice's protocols for completion of dental records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
- Review the company’s web site to ensure that it contains up to date information including opening hours and the emergency out of hours contact telephone number for patients.
- Improve the security of the door into the decontamination room to prevent unauthorised access by members of the general public and provide an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008.
- Review the frequency of staff meetings to ensure all staff attend.
- Review the responsibilities to meet the needs of disabled patients and the requirements of the Equality Act 2010 with respect to patient access and toilet facilities.