Archived: PCH Dental Liskeard Community Hospital

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

PCH Dental Ltd provides a dental service for all age groups who require a specialised approach to their dental care and are unable to receive this in a General Dental Practice. CQC is currently processing an application to register a new manager Christopher Roberts who is also the Clinical Director of the company. 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. PCH Dental Ltd has 13 registered locations across Cornwall providing dental services. This inspection focussed on the one based at Liskeard Community Hospital.

The service provides oral health care and dental treatment for children and adults that have an impairment, disability and/or complex medical condition. People who come in to this category are those with a physical, sensory, intellectual, mental, medical, emotional or social impairment or disability, including those who are housebound.

Additional services provided are a sedation service in selected clinics where treatment under a local anaesthetic alone is not feasible and conscious sedation is required.

General anaesthetic (GA) services are provided for children in pain where extractions under a local anaesthetic would not be feasible or appropriate such as in the very young, the extremely nervous, children with special needs or those requiring several extractions and other treatment. This service was also provided for adults with special needs such as those with moderate to severe learning disabilities. GA procedures are delivered at Royal Cornwall Hospital Trust.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. At the inspection we also spoke with patients, parents and carers. In total five people provided feedback about the service.

We carried out an announced comprehensive inspection on 24 August 2015 as part of our planned inspection of all dental practice locations. The inspection took place over one day and was carried out by a lead inspector, a dental specialist adviser and an expert by experience to provide a view of the service from the patient’s perspective.

Our key findings were:

• Patients said they were treated with “exceptional” compassion, dignity and respect and they were involved in their care and decisions about their treatment during their appointments.

• There was a strong commitment across the staff team to providing co-ordinated and responsive assessments and treatment for patients.

• The location had effective local clinical leadership provided by a specialist in special care dentistry. Staff followed current professional guidelines in areas of special care dentistry, general anaesthesia and conscious sedation when caring for patients.

• Patient safety was promoted by all the staff. Analysis of risks was evident at senior management level and actions were reported to the parent company, which provided a further tier of governance. Shared learning took place and was communicated through newsletters to all staff.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.

• Infection control procedures were comprehensive and the practice followed published guidance. The environment was visibly clean and well maintained.

• Effective safeguarding processes were in place for safeguarding adults and children living in vulnerable circumstances.

• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).

• Complaints were dealt with in an open and transparent way by the service and apologies given if a mistake had been made.

• The practice had a rolling programme of clinical and non-clinical audit in place to share learning and improve the service for patients.

• The practice had good facilities including disabled access and recognised there were areas such as signage and information presentation which could be improved in consultation with disabled patients.

• PCH Dental Ltd was working in collaboration with the local authority on a campaign entitled ‘Brighter Smiles’ to promote better dental health for children across Cornwall. This involved staff visiting schools, providing oral health education and information packs for parents and children about healthy eating and cleaning teeth.