CQC Hotspots – March 2017

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Reviewing a further sample of 56 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 56 practices sampled, 5 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 Well Led standard.

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.

  • Every month, two or three practices are being picked up on inadequate recruitment and staff induction procedures. Follow simple checklists and procedures to demonstrate that you are doing things correctly and keep records in staff files.
  • Ensure you are receiving, checking and taking action on relevant MHRA/CAS patient safety alerts. Dental practices don’t receive many but there must be a robust system in place to show that you identify and respond to any that are published.
  • Ensure that all sterilisation and clinical equipment is externally validated by professionals/suppliers in addition to the recommended routine/daily/weekly checks you are required to undertake.
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  • 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.
  • X-ray audits for quality and justification should be undertaken for each dentist, not on an individual surgery/equipment basis, as this could leave some dentists unchecked. Records should show all dentists are regularly audited.
  • Prescription and controlled medicines/drugs must be locked away and closely monitored.
  • Management of sharp injuries are regularly checked. Ensure procedures are in place and communicated to all the team. Incident/Accident Reporting records must be updated for each event.
  • The practice Health & Safety risk assessment must be kept up to date and where new or changed risks are identified, actions put in place to resolve quickly. Don’t delay as once identified, you have a responsibility to correct.
  • Check your electrical system inspections and certificates are all in place and up to date including Portable Appliance Testing. Frequency of re-test will be confirmed during each visit/inspection. More details from the Health & Safety Executive here.
  • 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.
  • Don’t forget that associate dentists, therapists and hygienists should also have annual appraisals to review performance and identify training requirements.
  • Collecting and responding to patient feedback and comments is essential. Don’t just rely on the NHS Family & Friends test, which is just one specific measure.
  • Make sure that the Registered Manager/CQC lead has adequate time to complete all their duties and responsibilities. Practices have been picked up where the Principal dentist/owner has day to day responsibility but is in surgery for the majority of the week.
  • Take care with “Off the Shelf” or “In a Box” Policy and Procedure packs. They are an essential and valuable source of material for many practices, but each policy/procedure must be reviewed and personalised to the practice and the way you work.
  • Make sure that all the named individuals/leads in your policies/procedures still actually work at the practice. Update and replacement is essential.
  • 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.
  • Ensure your fire procedures make provision for evacuation of patients with disabilities.
  • Don’t forget to book regular team meetings into the diary – ideally monthly – and keep records of agendas, minutes and action points from each. It is not enough for staff to say that everything is discussed and resolved informally during the working day.

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 – March 2017

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

Building a Closer, Stronger Team

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A smooth-running, cheerful, successful practice with an enviable reputation for patient care is all linked to the strength, power and commitment of your practice team.

Successful teams have a number of key qualities including:

  • A good leader with vision, tact, diplomacy and focus
  • Individuals pull together and act as one team
  • All understand what makes a good week and what the practice is trying to achieve
  • Everyone contributes a fair share to the team’s workload
  • No hidden or personal agendas
  • Individuals spot when others need support and offer to help
  • All recognise the strengths and contribution of others
  • Open, honest and thoughtful communication
  • A varied range of skills, knowledge, personalities and characters
  • Good working relationships with, and respect for, each other
  • Recognise and adapt to the different ways in which people approach work
  • Enjoy working together

Team-building sessions for practices are often focused on the the ever-popular bowling, theme-parks and nights out at the local restaurant or wine bar. All good fun, great for morale and definitely help to develop one or two of the team qualities – but what about the rest?

How can you start to understand:

  • What makes you and others within the team tick?
  • How you and your colleagues like to work?
  • What is important to you and your colleagues?
  • How you react to others and how others see you?
  • How best to communicate with the team and individuals?
  • How best can your Manager, manage the team?
  • How best can your Leader, lead the team?

As a certified trainer and facilitator for Everything DiSC®, I can now help you strengthen and develop your practice team through a real understanding of all the above, pulled together and delivered in a fun and interactive workshop supported by individual work-style profiles for each of the team.

DiSC Certified Trainer Blue PNG SmallAhead of the 2 – 3 hour workshop, all members of the team complete a simple on-line questionnaire which assesses the way they like to work, how they react in typical work environments and how they like to work as part of a team.

From this we generate a comprehensive, but very easy to read and understand, 20 page profile highlighting and discussing the strengths and impact of each individual’s preferred work-style, priorities and role within the team, on others. Everyone gets to take this away with them after the workshop for personal development and to keep as a reminder or prompt.

The profiles are also great for both the team member and team leader to use as part of personal development planning.

We see these different styles all around us but often individuals don’t understand or know how to react which then causes friction and misunderstanding.

Each of us has elements from each of the four DiSC styles within our character – the proWorkplace-Circle_thumbfiles and workshop highlight where your preferences lay and which areas of work or team communication may take you outside of your comfort-zone.

Further value comes from personalised guidelines and recommendations within the profile on how to use your own strengths to work with others in the team who will inevitably have their own preferred style of working.All styles are seen as equally important and the workshop focuses on making the most of each style.

During the workshop, we fully explore the different working styles, ways in which teams interact and how all teams benefit from a healthy mix of individual styles which together make the team stronger, more focused and usually, happier.

To book or find out more about the team workshop and Everything DiSC profiles, contact Your Dental Manager here
Building a Closer, Stronger Team