Archived: Dental Hospital

This service has not been inspected before

We rated it as outstanding because:

• The dental hospital had good links to the trusts safeguarding team. All clinicians and dental nurses were required to complete level three safeguarding training. Staff were knowledgeable about the signs and symptoms of abuse and neglect.
• Premises and equipment were clean and well maintained. Emergency equipment and medicines were readily available which reflected nationally recognised guidance. X-ray equipment was serviced and maintained in line with the Ionising Radiation Regulations (IRR 2017).
• Patient and staff safety was central to the service. There were systems in place to ensure care and treatment was provided safely. These included the use of World Health Organisation surgical safety checklists and Local Safety Standards for Invasive Procedure checklists. The dental hospital had also developed a “Biopsy safety strategy”. This had been developed in order to mitigate the potential risks associated with oral mucosal biopsies.
• Care and treatment was provided in line with current evidence-based guidance and standards such as the National Institute for Health and Care Excellence, British Orthodontic Society, British Society for Disability and Oral Health and the Faculty of General Dental Practice. Patients were provided with oral health advice in line with the Department of Health’s ‘Delivering Better Oral Health’ toolkit 2017.
• Multidisciplinary working was used extensively throughout the dental hospital. Examples included a joint child and adolescent trauma clinic, a hypodontia clinic and involvement in the regional Behcets Syndrome of Centre of Excellence. The special care dentistry department worked closely with several other teams within the trust including the haematology department at the main hospital site. Staff within this department ensured that they took a multidisciplinary approach to all their work to ensure treatment was carried out safely and in a compassionate manner.
• Feedback from people who used the service and those who are close to them was continually positive about the way staff treated people. People told us that staff go the extra mile and their care and support exceeds their expectations. Staff made adjustments to enable patients to access dental treatment. For example, we were told that special care patients could be brought through a different entrance to the dental hospital as it was quieter than the main entrance.
• Patients were treated with dignity and respect and staff provided compassionate care to those with physical, mental, social and medical impairment. Staff in the special care dentistry department had developed a memory box which could be used to provide mental and emotional stimulation for patients living with a memory loss condition such as dementia.
• Staff within the dental hospital had carried out a study about “Meeting and greeting in the clinical setting – are we doing what patients want?”. This identified the importance of identifying a patients’ personal preference at the first encounter about how they wished to be referred to. This study also highlighted the importance of staff introducing themselves and identifying their training grade and an explanation of what the training grade means.
• The service was designed to meet the needs of the local population. Reasonable adjustments had been made to the dental hospital to enable those with physical and medical impairments to access care. This included, step free access, lowered reception desks, lifts to all floors, accessible toilets and automatic doors. Translation services were available for patients who did not have English as a first language.
• There was compassionate, inclusive and effective leadership at all levels. Leaders at all levels demonstrated high levels of experience, capacity and capability needed to deliver excellent and sustainable care. There were clear responsibilities, roles and systems of accountability to support good governance and management.
• Staff at all levels were empowered and proactively encouraged to speak up it they have any concerns. All staff had an equal voice and they told us they felt able to speak up and raise concerns without fear of recrimination.
• Staff within the dental hospital maintained good links with the local dental community though the Managed Clinical Networks, Local Dental Committees and the Local Dental Network.

However:

• The waiting list for the paediatric department was excessive. Data showed 41.9% of children were treated within 18 weeks of referral at October 2018. This had worsened since October 2017 when the compliance with the 18 week referral to treatment target was 54.7%.There was work going on to reduce this waiting list.
• The system for monitoring the minimum and maximum fridge temperatures was not effective.
• The system for monitoring the use of prescriptions was not effective.