We carried out an announced comprehensive inspection on 3 March 2016 to ask the practice the following key questions; Are services safe, effective, 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 well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

We undertook this focused inspection to check the practice had followed their plan and to confirm they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Burlington Dental Practice on our website at www.cqc.org.uk.

CQC inspected the practice on 6 October 2015 and asked the registered provider to make improvements regarding clinical audits, completion of dental care records, policies and protocols, including the recruitment policy and checking medical emergency equipment. We checked these areas as part of this follow-up focussed inspection and found this had been resolved.

Burlington Dental Practice is situated in Goole, East Riding of Yorkshire. It offers predominantly NHS treatment to patients of all ages and some private dental treatments. The services include preventative advice and routine restorative dental care.

The practice has two surgeries, one decontamination room, an X-ray processing room, a waiting area and a reception area. Treatment and waiting rooms are on the ground floor of the premises. The decontamination room and patient toilet are on the first floor.

The practice is open:

Monday/Wednesday/Thursday and Friday 08:30 – 17:00.

Tuesday 08:00 – 19:00.

There is one dentist, two registered dental nurse, one trainee dental nurse and a practice manager at this practice.

Our key findings were:

• A system had been implemented to ensure weekly checks of medical emergency medicines and equipment was in place.
• Clinical records were details and contemporaneous, X-rays were justified, graded and reported on and treatment options discussions were recorded.
• A stock rotation system put in place and a list of all material dates was visible where the excess stock was stored.
• Rubber dam was now used for all stages for root canal treatment; this was also recorded within the patient dental care records.
• The cleaner had a folder with policies and contracts. The practice had set out guidance on what areas they wanted cleaning and had a daily task sheet available for completion.
• Prescriptions pads were audited, secured and a log kept for safety.
• Audits including patient dental care records and X-rays had been implemented to a high standard. All audits had an action plan and learning outcomes associated with their findings.
• The complaints policy was now available within the waiting room for patients and it contained time scales and external agency information.
• All policies and protocols within the practice had been reviewed and updated.
• Staff training files were available and had relevant information regarding courses.
• Recruitment files showed copies of identification, references, immunity status and qualification certificate.

We carried out an announced comprehensive inspection on 06 October 2015 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 not 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

Burlington Dental Practice is situated in Goole, East Yorkshire. It offers predominantly NHS treatment to patients of all ages and some private dental treatments. The services include preventative advice and routine restorative dental care.

The practice has two surgeries, one decontamination room, an X-ray processing room, a waiting area and a reception area. Treatment and waiting rooms are on the ground floor of the premises. The decontamination room and patient toilet are on the first floor.

The practice is open:

Monday/Wednesday/Thursday and Friday 08:30 – 17:00.

Tuesday 08:00 – 19:00.

There is one dentist, one registered dental nurse, one trainee dental nurse and a practice manager at this practice.

The practice owner 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.

During the inspection we spoke to three patients who used the service and we also reviewed 31 CQC comment cards. All the comments were positive about the staff and the services provided. Comments included: the practice was safe and hygienic; staff were very caring and polite and they were impressed with the services.

Our key findings were:

• Patients were treated with care, respect and dignity.
• There were clearly defined leadership roles within the practice and staff told us that they felt supported, appreciated and comfortable to raise concerns or make suggestions. Staff received training appropriate to their roles.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to manage medical emergencies.
• Infection control procedures were in accordance with the published guidelines.
• The appointment system met patients’ needs.

We identified regulations that were not being met and the provider must:

• Review the practice's protocols for completing dental records giving due regard to guidance provided by the Faculty of General Dental Practice in respect of clinical examinations and record keeping.
• Ensure all audits have a documented action plan with guidance on improvements required and timescales for review.
• Ensure the practice’s protocols for the taking of X-rays giving due regard to the Faculty of General Dental Practice (FGDP) guidance on the 'Selection Criteria for Dental Radiography

• Ensure availability of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

• Ensure the practice’s sharps handling procedures and protocols are in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2014.

You can see full details of the regulations not being met at the end of this report.

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

• Review the practice protocol for the manual scrubbing of instruments.
• Aim to record daily tests conducted on the autoclave.

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review the complaints policy including information about reporting to external agencies including the ombudsman and the General Dental Council (GDC) – the statutory body responsible for regulating dentists, dental therapists, dental hygienists, dental nurses, clinical dental technicians and dental technicians.
• Accessibility to the complaints procedure through practice information leaflets and patient waiting room information.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the-X-rays and reporting on the X-rays giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.