Updated 27 June 2022
We carried out this announced focused inspection on 1 June 2022 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 adviser.
To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:
• Is it safe?
• Is it effective?
• Is it well-led?
These questions form the framework for the areas we look at during the inspection.
Our findings were:
- The dental clinic appeared to be visibly clean and well-maintained.
- The practice had infection control procedures which mostly reflected published guidance.
- Staff knew how to deal with medical emergencies. Appropriate medicines and most life-saving equipment were available. However, the process for ensuring that the medicine used to treat low blood sugar (glucagon) was effective needed strengthening. Missing equipment and an alternative form of the medicine used to treat seizures was obtained after the inspection.
- The practice had some systems to help them manage risk to patients and staff although there were shortfalls in the management of risk associated with Control of Substances Hazardous to Health for dental products.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The five yearly electrical fixed wire testing had not been undertaken. This was completed after the inspection.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- The dental clinic had information governance arrangements.
- The practice had staff recruitment procedures which mostly reflected current legislation.
Background
The provider has one practice, and this report is about Bowers Way Dental Surgery.
Bowers Way Dental Surgery is in Harpenden and provides NHS and private dental care and treatment for adults and children.
Access to the practice for people who use wheelchairs and those with pushchairs is via a small ramp. Car parking spaces, including dedicated parking for people with disabilities, are available in a pay and display car park next to the practice. The practice has made some adjustments to support patients with additional needs.
The dental team includes five dentists, three dental nurses, including two dental nurse trainees who also work on reception and two hygienists. The practice has three treatment rooms.
During the inspection we spoke with three dentists, and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday and Wednesday from 9am to 5.30pm
Tuesday from 11am to 7pm
Thursday and Friday from 9.30am to 6pm
There were areas where the provider could make improvements. They should:
- Take action to ensure the availability and monitoring of medicines and equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
- Ensure there are systems in place to track and monitor NHS prescription pads in the practice and complete an antimicrobial prescribing audit to ensure that clinicians are prescribing in line with current guidance.
- Improve the practice's processes for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.
- Take action to ensure dentists are following the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.