East Finchley Smiles

We carried out this unannounced comprehensive inspection on 14 July 2023 under section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

We planned the inspection to check whether the registered practice was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations.

The inspection was led by a Care Quality Commission (CQC) inspector who was supported by a specialist dental advisor.

To get to the heart of patients' experiences of care and treatment, we always ask the following 5 questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people's needs?
• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• Clinical staff provided patients' care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients' privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients' needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• Complaints were dealt with positively and efficiently.
• The dental clinic did not appear clean or well-maintained.
• The practice infection control procedures did not reflect published guidance.
• Staff did not know how to deal with medical emergencies. Appropriate medicines and life-saving equipment were not available.
• The practice did not have systems to manage risks for patients, staff, equipment and the premises.
• Safeguarding processes were not in place and staff did not know their responsibilities for safeguarding vulnerable adults and children.
• The practice did not have suitable recruitment procedures to comply with current legislation.
• There was ineffective leadership and a lack of oversight of the day-to-day management of the service.
• There were ineffective systems to support continuous improvement.
• Patients were not asked for feedback about the services provided.
• The practice had information governance arrangements. Improvements were needed to the protocols for the use of closed-circuit television cameras.

Background

East Finchley Smiles is in the London Borough of Barnet and provides NHS and private dental care and treatment for adults and children.

There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes the principal dentist, 3 associate dentists, 2 qualified dental nurses, 1 trainee dental nurse, 1 dental hygienist, 1 practice manager and 2 receptionists. The practice has 2 treatment rooms.

During the inspection we spoke with principal dentist, the practice manager, 1 qualified dental nurse and 1 receptionist. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday to Friday 9am to 5pm.

We identified regulations the provider was/is not complying with. They must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider was not meeting are at the end of this report.

There were areas where the provider could make improvements. They should:

Take action to ensure audits of record keeping and antimicrobial prescribing are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.