We carried out an announced inspection of this practice on 12 April 2016. Breaches of legal requirements were found. After the inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to safe care and treatment.

We undertook this focused inspection to check they had followed their plan and to confirm they had 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 Clock House Dental on our website at www.cqc.org.uk

Our findings were:

Are services Safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Background

Clock House Dental Practice is situated in Heworth Village area of York, North Yorkshire and is situated over three floors. Three surgeries are located on the ground floor of the practice and a further five are located on the first floor. There are eight dentists (two are the owners/Clinical Directors), a team leader, seven dental nurses (three of which are trainees) four receptionists including a reception supervisor, a lead decontamination nurse and a Dental Hygiene Therapist.

The practice offers a mix of NHS and private dental treatments including preventative advice, routine restorative dental care, private Orthodontic treatments and Dental Implants.

The practice is open:

Monday - Friday 08:30 – 17:00

One of the practice clinical directors 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.

Our key findings were:

• The practice had implemented Control of Substances Hazardous to Health (COSHH) risk assessments for all dental materials used within the practice.
• The practice had completed all practice risk assessments including legionella and fire.
• The practice's recruitment policy and procedures were now suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This is 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, in particular all staff now held Disclosure Baring Service checks (DBS).

We carried out an announced comprehensive inspection on 12 April 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 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 providing well-led care in accordance with the relevant regulations.

Background

Clock House Dental Practice is situated in Heworth Village area of York, North Yorkshire and is situated over three floors. Three surgeries are located on the ground floor of the practice and a further five are located on the first floor. There are eight dentists (two are the owners/Clinical Directors), a team leader, seven dental nurses (three of which are trainees) four receptionists including a reception supervisor, a lead decontamination nurse and a Dental Hygiene Therapist.

The practice offers a mix of NHS and private dental treatments including preventative advice, routine restorative dental care, private Orthodontic treatments and Dental Implants.

The practice is open:

Monday - Friday 08:30 – 17:00

One of the practice owner/Clinical Directors 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.

On the day of inspection we received 21 CQC comment cards providing feedback. The patients who provided feedback were positive about the care and treatment they received at the practice. They told us they were involved in all aspects of their care and were very pleased with the service. They found the staff to be helpful, gentle, patient and friendly. Also the staff had good communication skills, were efficient and they treated patients with dignity and respect in a clean and tidy environment.

Our key findings were:

• Staff had been trained to manage medical emergencies.
• Infection prevention and control procedures were in accordance with the published guidelines.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current regulations.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The practice sought feedback from staff and patients about the services they provided.

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

• Ensure COSHH risk assessments for all dental materials used within the practice are implemented.
• Ensure all practice risk assessments are implemented and reviewed including legionella and fire.
• Ensure the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule three 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, in particular Disclosure Baring Service checks (DBS).

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

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

• Review the practice protocol is implemented for receiving, sharing and acknowledging alerts by email from the Medicines and Healthcare products Regulatory Agency (MHRA), the UK’s regulator of medicines, medical devices and blood components for transfusion, responsible for ensuring their safety, quality and effectiveness.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to the guidelines issued by the British Endodontic Society.
• Implement a detailed plan to review what the practice requires to meet best practice guidelines set out according to the Department of Health's guidance, Health Technical Memorandum 01-05 (HTM 01-05).
• Review the practice confidentiality policy with regard to the use of CCTV cameras within the dental practice and ensure all information, assessments and signage are implemented as per the Information Commissioning Office (ICO) recommendations.
• Review the storage of dental care products and medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.
• Review the process to ensure staff are up to date with their mandatory training and their Continuing Professional Development (CPD).
• Review the process to ensure all clinical staff have completed an up to date level two safeguarding adults and children course.