CQC Hotspots – February 2017

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Reviewing a further sample of 54 CQC dental inspection reports published over recent weeks, highlighted a number of compliance breaches which can easily be avoided, but which are still catching out some practices.

Of the 54 practices sampled, 6 practices were issued with breach notifications. Clearly the vast majority of practices are still getting things right, which is great news. All notices reviewed this month were issued for breaches within the Safe and Well Led standards.

In the spirit of continuous improvement and to try and help 100% of practices achieve a clean pass, here are some of the key-findings and recommendations from these very recent inspections, which might just keep another practice out of trouble.

  • Check to make sure that your recruitment policies and procedures are in place, up to date and followed closely. Particularly with regards to DBS checks, references and evidence of right to work in the UK
  • Ensure you are receiving, checking and taking action on relevant MHRA/CAS patient safety alerts
  • Ensure that patients don’t have access to empty surgeries, which should ideally be locked when not in use, or access restricted
  • Make sure prescription pads are kept securely and not left unattended
  • Always make sure that screens of unattended PCs are locked to avoid unauthorised access and switched off when not required
  • Check your training records are complete and up to date, particularly individual training records for Infection Control, Information Governance, Safeguarding and Health & Safety
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  • Dental materials must be kept securely and not accessible to patients
  • Don’t forget to record and keep vaccination records, including Hep B records, up to date for all clinical staff
  • X-Ray equipment should always be switched off at the master switch when not in use
  • General cleaning equipment should be stored securely, colour coded and segregated from clinical cleaning
  • Audits are still seen without essential evidence of learning and action points. Don’t treat audits as a box-ticking exercise, use them to identify and resolve short-comings
  • Make sure you implement recommendations from any risk assessments e.g. regular water temperature checks as part of your Legionella report
  • Remember to clearly define and respect “clean” and “dirty” zones within surgeries and decontamination units
  • All Lab work returned to practice should be disinfected before placement and evidenced on Lab records
  • Inspectors continue to come across missing or partially-completed, mandatory risk assessments including Sharps, Fire, Clinical Waste, COSHH and Manual Handling
  • Remember to date and review all of your practice policies and procedures at least annually. If nothing has changed simply re-date to show that you have been there.
  • Make sure that staff and patients have the opportunity to provide feedback and express concerns. Just as importantly, do something about the feedback and show you have listened
  • Check that dental records are being updated contemporaneously – ie during or immediately after the appointment
  • Some practices still don’t have a Radiation Protection Adviser appointed – this is mandatory
  • Make sure quality and safety audits are carried out on x-ray equipment in line with RPA/manufacturer recommendations
  • Back to basics – don’t forget daily testing and recording of your autoclave equipment
  • The practice is responsible for overseeing CPD training – make sure you keep records of where everyone is within their CPD training cycle
  • Keep on top of your fire log book and mandatory checks of fire equipment including  alarms and emergency lighting
  • Don’t forget to book regular team meetings into the diary – ideally monthly – and keep records of agendas, minutes and action points from each

As always, remember that if something is not recorded or evidenced, in the eyes of the CQC and other external bodies such as the NHS, it didn’t happen, even though you may know full well that it did! This continues to catch practices out, leading to frustration and avoidable stress for all!

Findings from previous inspection reviews can be found here:  CQC Hotspots

There is plenty of help out there to plug any management gaps including Your Dental Manager, so please do get in touch if you have any concerns or want to further improve the overall management/efficiency of your practice: info@yourdentalmanager.co.uk or check our on-line calendar to book a complimentary chat.

CQC Hotspots – February 2017

Make a Difference With Your Practice Appointment Diary

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Your practice appointment diary is a powerful tool at the heart of your business, with the Planning meetingpower to make or break the day for yourself, the team and your patients.

Left to run itself, without thought and planning, you will at best experience “organised chaos”. You will certainly know who is due in, when and hopefully why – but you and the team are always at the mercy of whatever has been randomly booked in, from routine checks to complex root canal treatments.

Here are some of the scenarios often seen when visiting practices

  • Queues in the waiting room as multiple patients arrive for short appointments – some arrive early, others arrive late – all seem to arrive at the same time
  • Multiple routine dental health checks in multiple surgeries at the same time
  • Patients leave the surgery without making payments or booking their next appointment due to a busy reception – more work to be done later
  • Telephones go unanswered as patient queues and over-running appointments are managed
  • Dental nurses making multiple journeys to the decontamination unit from multiple surgeries
  • Shortage of exam kits due to a backlog of sterilisation – even more to be purchased
  • No time to actively talk to patients as clocks and watches are checked by patients, receptionists and clinicians
  • Clinical earnings and hourly rates are down down despite being very busy
  • The next available appointment for a complex treatment is 5 weeks ahead
  • Receptionists tasked to fill the diary with any appointment at any time.
  • Plenty of white space in the diary but can I find a treatment slot for more than 30 minutes? Add this white space together and we have a surprising amount of downtime.

A realistic solution is to take control of your appointment diary and start by creating regular “Treatment Blocks” for more complex treatments.

  • No recalls/routine appointments to be booked into the Treatment Blocks
  • Zone out different Treatment Blocks for different surgeries sat different times o that when one surgery has low patient volumes another surgery has more recall appointments to smooth out patient volumesEducation concept: Think Different on digital background
  • Create as “Clinics” or equivalent so that your practice software doesn’t offer the Treatment Blocks when searched for recall appointments
  • Number and length of Treatment Blocks will be dependent on the split of work you have between routine recalls/health checks and treatment opportunities
  • Minimum 2 hour blocks to ensure time for either one or two complex treatments
  • Vary the days and use both morning and afternoon blocks to provide more choice to patients – maybe try a rolling 4 week rota of different days/sessions
  • Patients requiring treatment are often more flexible with time than recall patients – treatment blocks can make good use of mid-morning and mid afternoons – leave peak times for recall patients
  • The clinician has shared responsibility to fill treatment blocks by identifying patients  for treatment and advising reception to utilise next available slot
  • Reception can follow-up treatment plans and book patients into available treatment slots
  • Release any unused treatment block time two days prior to the date to allow time for reception to call short-notice patients, book in urgent appointments

A few of the benefits you will soon start to see from implementing Treatment Blocks:

  • Smoother flow of patient volumes across the week and working day
  • Increased take-up of Treatment Plans
    • Patients can be booked in quickly whilst discussions are still fresh in the mind
    • Improved service for patients
    • Patients feel more valued and appreciated
    • Reduced chance of appointments being cancelled if available within a few days
  • Reduced pressure on reception with less peaks and troughs of demand
  • Reduced pressure on clinicians and dental nurses from a healthy mixture of checks and treatments
  • Reduced pressure on decontamination facilities and availability of exam kits
  • Improved patient journey
  • Improved telephone-handling capacity across the working day and week
  • More consistent cash-flow, hourly rate and clinical earnings from a steady mix of checks and treatments
  • Incentive for clinicians to book patients in for treatment sooner rather than later
  • Calmer practice environment

There is plenty of help  and support out there to help you make a difference to your business, including Your Dental Manager, so please do get in touch to find out more:  info@yourdentalmanager.co.uk or check our on-line calendar to book a complimentary chat.

 

 

Make a Difference With Your Practice Appointment Diary

CQC Hotspots – December 2016

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Reviewing a further sample of 52 CQC dental inspection reports published in December, highlighted a number of compliance breaches which can easily be avoided.

Of the 52 practices sampled, 5 practices were issued with breach notifications. Clearly the vast majority of practices are still getting things right, which is great news.

In the spirit of continuous improvement and to try and help 100% of practices achieve a clean pass, here are some of the key-findings from these very recent inspections, which might just keep another practice out of trouble.

  • Always have evidence of checking and taking action on MHRA/CAS safety alerts
  • Have a system in place re RIDDOR reporting requirements for significant incidents
  • Policies and procedures should also be personalised and made relevant to your practice – don’t just leave them as generic operating procedures
  • Check your training records are complete and up to date, particularly individual training records for Infection Control, Information Governance, Complaints and Health & Safety
  • Details of local, external contacts for adult/child safeguarding concerns are up to date and readily available
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  • Medical Emergency procedures should be tested and rehearsed
  • At least two CPR trained members of staff should be on-site whenever patients are in practice
  • Don’t forget to record and keep Hep B records up to date for all clinical staff
  • Please allow trainee nurse assessors access to surgery, with patient agreement, to enable them to supervise your trainee staff
  • Audits are regularly seen without essential evidence of learning and action points.
  • Remember that carpets should never be seen in any clinical/patient areas
  • When testing your basin water temperatures, don’t ignore when minimum temperatures are not being reached
  • Unclear or incomplete patient records continue to feature including the need to show evidence of health advice/best practice and compliance with NICE/FGDP/DH guidelines
  • Evidence compliance with a preventative approach to dental care in line with DH publication “Delivering Better Oral Health” in patient records
  • When radiography equipment is relocated or newly installed, local rules must be updated and the equipment tested by your RPA
  • Mental Capacity Act 2005 and Gillick competency requirements are almost always tested – make sure procedures are in place and well understood by the team
  • Check you have a detailed practice information leaflet, which is up to date and in line with NHS England/CQC requirements
  • Opening hours of the practice should always be on display to patients
  • CCTV is becoming more common – remember that there must be a policy in place, information notices provided for patients and use of CCTV must be registered with the Information Commissioners Office (ICO)

As always, remember that if something is not recorded or evidenced, in the eyes of the CQC and other external bodies such as the NHS, it didn’t happen, even though you may know full well that it did! This continues to catch practices out, leading to frustration and avoidable stress for all!

Findings from previous inspection reviews can be found here:  CQC Hotspots

There is plenty of help out there to plug any management gaps including Your Dental Manager, so please do get in touch if you have any concerns or want to further improve the overall management/efficiency of your practice: info@yourdentalmanager.co.uk or check our on-line calendar to book a complimentary chat.

CQC Hotspots – December 2016

CQC Hotspots – November 2016

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Reviewing a further sample of 50 CQC dental inspection reports published in November, highlighted a number of breaches which can easily be avoided.

Shortcomings were spread across the “Safe”, “Effective” and “Well Led” criteria. Recruitment procedures continue to feature prominently as does knowledge of the Mental Capacity Act 2005 and it’s impact on valid consent.

Of the 50 practices sampled, just 4 practices were issued with breach notifications. Clearly the vast majority of practices are getting things right, which is great news.

In the spirit of continuous improvement and to try and help 100% of practices achieve a clean pass, here are some of the key-findings from these very recent inspections, which might just keep another practice out of trouble.

  • Regularly share your policies & procedures with the team and ensure everyone knows where they can be found. Don’t leave them “on the shelf”.
  • Keep your policies and procedures up to date with regular reviews and always date the review as evidence. Any changes/updates must be communicated to the team.
  • Inadequate recruitment checks and procedures including right to work, references and qualification checks continue to feature regularly. Make sure your staff files are well organised and compliant. Use checklists to ensure everything is covered and evidenced.
  • Missing or incomplete training records. Particularly individual training records for Infection Control, Information Governance, Complaints and Health & Safety.
  • Make sure the team have a good understanding of safeguarding for children and vulnerable adults, with local referral points identified and easily accessible.
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  • Check that you have a valid Legionella Risk assessment and that all recommended checks are being actioned.
  • Inadequate Medical Emergency kit/supplies. Make sure you comply with the Resuscitation Council/GDC guidelines.
  • Not seeking or reacting to patient feedback. Make sure you have comment forms and collection box easily accessible to patients. Don’t forget to review and action the contents.
  • Irregular, or no, team meetings.  Make sure you hold meetings more than once or twice a year (preferably monthly), to keep everyone up to date and include lessons learned from audits/patient feedback. Remember to keep meeting minutes to evidence discussions.
  • Audits without essential evidence of learning and action points.
  • Missing or inadequate reporting of significant incident records, including follow-up actions and discussions. Make sure the team are aware of your procedures and learning points.
  • No evidence of tracking, monitoring and reacting to patient safety reports, including CAS and MHRA.
  • The Duty of Candour continues to be checked regularly. Make sure this is understood by all the team and that the procedures/working environment are in place to encourage openness and honesty.
  • Unclear or incomplete patient records have started to feature including the need to show evidence of health advice/best practice and compliance with NICE/FGDP/DH guidelines.
  • Evidence compliance with a preventative approach to dental care in line with DH publication “Delivering Better Oral Health”.
  • Patient records should clearly show treatment options available to patients and evidence of patients making an informed decision.
  • Make sure inexperienced/trainee staff have adequate supervision, mentoring and support.
  • Smaller practices in particular, need to ensure that they have robust referral procedures in place to ensure all patient needs are met and medical concerns escalated.
  • One practice was picked up for not using a rubber dam during root canal treatment
  • Regularly check use-by dates on stock in surgeries, emergency medical supplies and reception consumables to ensure none go out of date.
  • Check that all your dentists are up to date with Radiography training and that you have a Radiation Protection Adviser (RPA) appointed at all times.

As always, remember that if something is not recorded or evidenced, in the eyes of the CQC and other external bodies such as the NHS, it didn’t happen, even though you may know full well that it did! This continues to catch practices out, leading to frustration and avoidable stress for all!

Findings from previous inspection reviews can be found here:  CQC Hotspots

There is plenty of help out there to plug any management gaps including Your Dental Manager, so please do get in touch if you have any concerns or want to further improve the overall management/efficiency of your practice: info@yourdentalmanager.co.uk or check our on-line calendar to book a complimentary chat.

 

CQC Hotspots – November 2016

Senior Receptionist – Oxford

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An exciting opportunity has arisen for an ambitious, experienced, multi-skilled receptionist, to join an expanding group of dental practices in Oxford to take responsibility for the day-to-day management and growth of a city-centre, satellite practice.

The established, satellite practice currently operates 2.5 days per week with one dentist.

The successful candidate will be employed full-time to grow and market the dental practice, whilst providing a comprehensive patient reception service, with full support and backing of the central practice and practice owner.

Local relocation of the practice is highly likely over the next 12 months to take advantage of growth and new opportunities in the area.

The role brings an attractive full-time salary of up to £18k, dependent on experience, with potential for an annual bonus of up to £2,000 linked to growth in patient numbers and excellent career prospects.

Dental practice background and experience is required for the successful candidate to ensure the role can be quickly taken on board and developed.

A more detailed job profile can be seen here.

If you feel that your skills, experience and ambitions are ideal for this opportunity, please send your c.v. and a covering letter outlining the value you can bring to: oxford@yourdentalmanager.co.uk

Senior Receptionist – Oxford

CQC Hotspots – October 2016

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Reviewing a further sample of 24 CQC dental inspection reports published in October, highlighted a number of breaches which can easily be avoided.

Of the 24 practices sampled, 7 practices were issued with breach notifications which is significantly higher than previous samples undertaken. Shortcomings were again found mainly across the “Well Led” and “Safe” criteria.

We are starting to see more practices picked up for out of date policies, procedures, audits and check-lists. Always important to keep on top of all the good work done in the past and keep everything up to date.

In the spirit of continuous improvement and to try and help 100% of practices achieve a clean pass, here are some of the key-findings which might just keep another practice out of trouble.

  • Effectiveness of policies and procedures is featuring strongly. Make sure that you don’t rely on “out of the box templates”. These are very useful but must be tailored/personalised to your practice and reflect what actually happens on a day to day basis. Always share with the team and ensure everyone knows what your policies/procedures are. Don’t leave them “in the box”.
  • Policies and procedures are not always kept up to date, regularly reviewed, updated and shared across the team.
  • Out of date risk assessments and critical audits including 6 monthly Infection control and radiography checks.
  • Inadequate recruitment checks and procedures including right to work, references and qualification checks. Make sure your staff files are well organised and compliant.
  • Missing or incomplete staff appraisals, personal development plans and training records.
  • COSHH records and fact-sheets not being completed, or updated, as different products/materials are introduced into the practice.
  • No Business Continuity plan – unexpected events happen and you need to be prepared as a practice.
  • Inadequate or missing safeguarding training for children and vulnerable adults – dreamstime_xs_43893109always make sure the team know how and where to raise concerns.
  • Out of date portable appliance and gas safety checks pose a risk to the practice and your patients.
  • Legionella reports left in the drawer with recommendations not fully implemented, particularly the recording of regular temperature checks for taps.
  • Inadequate Medical Emergency kit/supplies. Make sure you comply with the Resuscitation Council and GDC guidelines.
  • Missing or inadequate sharps/stick injury policies and procedures to follow in the event of an incident.
  • Not seeking or reacting to patient feedback. Make sure you have comment forms and collection box easily accessible to patients. Don’t forget to review and action the contents.
  • Irregular, or no, team meetings.  Make sure you hold meetings more than once or twice a year (preferably monthly), to keep everyone up to date and include lessons learned from audits/patient feedback. Remember to keep meeting minutes to evidence discussions.
  • Missing/out of date audits and checks. A robust diary system should be in place to ensure they are not missed and that the next audit date can be quickly evidenced/identified.
  • Audits without essential evidence of learning and action points.
  • Missing or inadequate reporting of significant incident records, including follow-up actions and discussions. Make sure the team are aware of your procedures.
  • No evidence of tracking, monitoring and reacting to patient safety reports, including CAS and MHRA.
  • The Duty of Candour requirement is often asked of staff during inspections. Make sure that candour is understood by all the team and that the procedures/working environment is in place to encourage.

Once again, always remember that if something is not recorded or evidenced, in the eyes of the CQC and other external bodies such as the NHS, it didn’t happen, even though you may know full well that it did! This continues to catch practices out, leading to frustration and avoidable stress for all!

Findings from previous inspection reviews can be found here:  CQC Hotspots

There is plenty of help out there to plug any management gaps including Your Dental Manager, so please do get in touch if you have any concerns or want to further improve the overall management/efficiency of your practice:info@yourdentalmanager.co.uk

CQC Hotspots – October 2016

Should We Have Our Own Smartphone Practice App?

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Apps seem to be everywhere these days and I am often asked by principal dentists and practice managers, whether an App would be of value to the practice and to patients.

The quick and easy answer is yes. . . . . There are many people out there who prefer to interact with businesses via their smartphone or other mobile device and don’t expect to pick up the desk phone or even send e-mails for routine, day-to-day tasks like booking an appointment or checking prices, availability, current offers etc.

Please accept that an App will not be of value or interest to everyone, which is fine but don’t ignore the ever-growing number of patients who do value them.

The key to effective marketing and patient communication is reaching out to patients at a time and in a way which suits individuals and we are all different. Every practice has patients who prefer to communicate with us in different ways, from the traditional letter and telephone through to e-mail , text and now directly through their smartphone or mobile device.

screen-shot-2016-10-28-at-4-16-21-pmSmartphone technology is increasingly becoming the norm and an anticipated part of business for many. Your patients will often do a search for associated Apps when buying a new product or service just as they generally seek out a website before purchasing.

One way I look at this is that your website is simply a shop-window for new and existing patients whilst your App gives patients quick and easy access to your services and allows them to interact with you more easily.

In addition to boosting your brand awareness by having your practice logo permanently sat on the patient’s smart-phone, some of the many other benefits are:

Your Practice:

  • Send messages directly to individual, or all, patient smartphones without charge
  • Receive patient appointment requests with all required information & contact details
  • Quickly confirm appointments
  • Easily create and administer loyalty schemes
  • Receive patient referrals quickly and easily
  • Automate patient enquiry forms for consistency and ease of use
  • Reduce volume of phone calls
  • Reduced volumes of outgoing e-mail and letters
  • Additional services/offers restricted to groups of patients e.g. Dental Plan members
  • Showcase your practice and treatments using picture galleries
  • Detailed reporting allows you to track activity and usage of the App and each feature
  • Simple content management system allows you to update and add content

 

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  • Request appointments with date/time preferences at any time
  • Less time spent on the telephone/writing e-mails
  • Convenient access at any time of the day or night
  • Access to special offers
  • Access to loyalty schemes
  • Access to your website and social media links all in one place
  • Quick notification of new services, offers and availability
  • Travel directions to your practice from any location
  • Quick and easy feedback

 

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Such is the value we attach to correctly managed, professional Apps for dental practices, Your Dental Manager has now invested in the technology to build and manage a bespoke App for your practice in-house, which will be built to meet the strengths and needs of you and your patients.

A simple, on-line, interactive  build request form will collate all the basic detail we need to produce a working version. This includes your logo, preferred images, features you would like to use and layout of the App itself.

 

Once finalised, we take care of all the work involved with publishing your new App to the Apple and Android stores, along with everything you need to share and spread details of how to download your new App to staff, patients, community contacts and of course family and friends. All of this is available for a one-off charge of £500 to cover design, publication, content management system and initial training, along with an ongoing monthly fee of £50 for support, maintenance and any necessary updates.

If you would like to discuss the benefits of a new App for your practice, contact Your Dental Manager at enquiries@yourdentalmanager.co.uk or even better, why not download our own App for Apple or Android and contact us using YDM Direct.

 

 

Should We Have Our Own Smartphone Practice App?