Archived: Woodgreen Dental Practice

Updated 12 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This announced inspection was carried out on 10 March 2016 by an inspector from the Care Quality Commission (CQC) and a dental specialist advisor.

During the inspection we viewed the premises, spoke with the dentist and dental nurse. To assess the quality of care provided we looked at practice policies and protocols and other records relating to the management of the service.

We also reviewed information we had asked the provider to send us in advance of the inspection. This included their latest statement of purpose describing their values and objectives.

We received feedback from 14 patients. All patients commented positively about dentists, dental nurses and reception staff. They described staff as caring and friendly.

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

Is it safe?

Is it effective?

Is it caring?

Is it responsive to people’s needs?

Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Prior to the inspection we reviewed information we held about the provider.

Updated 12 April 2016

We carried out an announced comprehensive inspection on 10 March 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 not 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

Wood Green Dental Practice provides NHS dental treatment to patients of all ages. The services provided include preventative advice and treatment and routine restorative dental care.

The practice staffing consists of a principal dentist and one dental nurse.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

The practice consists of one treatment room, a waiting area for patients and reception area, a staff room and a decontamination room.

The practice opening hours are Monday to Thursday 9.30am to 4.30pm and Friday 9.30am to 1pm.

14 patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received and about the service. Patients told us that they were happy with the dental treatment and advice they had received.

Our key findings were:

• There were sufficient numbers of suitably qualified staff to meet the needs of patients.

• Patients were treated with dignity and respect and patient confidentiality was maintained.

• The practice had a procedure for handling and responding to complaints.

• There were systems in place to ensure that equipment including the suction apparatus, compressor unit, autoclave and fire extinguishers had been serviced regularly.
• The practice had arrangements for receiving and responding to patient safety alerts issued from relevant external agencies.
• The practice had ensured that appropriate equipment in line with Resuscitation Council (UK) guidance, was available to respond to a medical emergency.

• Infection control protocols were being followed in line with recommended national guidance.

• The Principal dentist had not undertaken training in radiography and radiation protection. (Ionising Radiation (Medical Exposure) Regulations).
• The practice was not following national guidance in undertaking radiographs, and X-rays were not justified in line with the Ionising Radiation (Medical Exposure) Regulations 2000 (IRMER).
• Rubber dam was not being used for root canal treatment in line with national guidance.
• Patients’ care and treatment was not planned and delivered in line with current legislation and evidence based guidelines such as from the National Institute for Health and Care Excellence (NICE).
• The practice had carried out risk assessments to ensure the health and safety of staff and patients, but these had not been reviewed since 2013.
• Improvements could be made to ensure dental care records were being suitably completed in line with guidance provided by the Faculty of General Dental Practice.
• The practice had carried out audits in key areas, such as radiography and record keeping. Documented learning points and the resulting improvements however could not be demonstrated.

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

• Ensure that staff who are involved in undertaking radiographs have the appropriate training and skills to carry out the role giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IRMER) 2000.

• Ensure an effective system is established to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.
• Ensure systems are in place to assess, monitor and improve the quality of the service.

• Ensure audits of various aspects of the service, such as radiography and dental care records are undertaken at regular intervals to help improve the quality of service. The practice should also ensure that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.

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:

• Review the practice's protocols for completion of dental care records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IRMER) 2000.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.

• Review polices, procedure and risk assessment periodically.