We carried out an announced comprehensive inspection on 5 April 2016 to ask the practice the following key questions; Are services well-led?

Our findings were:

Are services well-led?

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

Background

CQC inspected the practice on 22 October 2015 and asked the registered manager to make improvements regarding clinical audits, policies and protocols in regards to Intravenous Sedation and ensure radiography equipment was critically examined; serviced and local rules are displayed. We checked these areas as part of this follow-up inspection and found these areas had been resolved.

Carlton House Dental Practice is situated in Knaresborough, North Yorkshire. The practice offers a mix of NHS and private dental treatments. The services include preventative advice, routine restorative dental care and conscious sedation.

The practice has four surgeries, a decontamination room, a separate room for the Orthopantomogram (OPT) machine (an OPT machine is a panoramic scanning dental X-ray of the upper and lower jaw), a reception area and a waiting area all on the ground floor level.

The practice is open:

Monday 08:30 - 18:30

Tuesday and Friday 08:30 – 17:30

Wednesday 08:30 – 19:00

Thursday 08:30 – 18:00.

There are three dentists, two hygienists, five dental nurses, two receptionists and a registered manager.

Our key findings were:

• The practice’s protocols, audits and training for Conscious Sedation are now in place, giving due regard to guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015.
• The Orthopantomogram (OPT) machine (an OPT machine is a panoramic scanning dental X-ray of the upper and lower jaw).had now been critically tested, certified and had local rules available for the machine.

We carried out an announced comprehensive inspection on 22 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 providing safe care in accordance with the relevant

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

Carlton House Dental Practice is situated in Knaresborough, North Yorkshire. The practice offers a mix of NHS and private dental treatments. The services include preventative advice, routine restorative dental care and conscious sedation.

The practice has four surgeries, a decontamination room, a dental panoramic x-ray room, a reception area and a waiting area all on the ground floor level.

There are three dentists, two hygienists, five dental nurses, two receptionists and a registered manager.

The practice is open:

Monday 08:30 - 18:30

Tuesday and Friday 08:30 – 17:30

Wednesday 08:30 – 19:00

Thursday 08:30 – 18:00.

The practice manager 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 eight CQC comment cards providing feedback and spoke to three patients. 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 found the staff to be caring and considerate and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• There was a complaints system in place. Staff recorded complaints and cascaded learning to staff.
• 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.
• Patient care and treatment was planned and delivered in line with evidence based guidelines, best practice and current regulations.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The governance systems were effective.
• 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 the practice’s protocols and audits for conscious sedation are reviewed, giving due regard to guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015'.

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:

• Update the Local Rules for radiography including the new radiation protection supervisors -RPS details.

• Review the dental panoramic X-ray machine is critically tested and certified.