We carried out this announced inspection on 14 August 2019 and 4 September 2019 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 provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
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 form the framework for the areas we look at during the inspection.
Our findings were:
Are services safe?
We found that this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found that this practice was 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
The Stafford Dental Practice is in Stafford and provides private treatment to adults and children.
There is ramped access to the rear of the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including one for blue badge holders, are available in the car park at the rear of the practice.
The dental team includes two dentists (the practice owners), two dental nurses, (including a trainee), one dental hygienist and a receptionist. The practice has two dental treatment rooms.
The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
During the inspection we received feedback from 13 patients.
This inspection was carried out over two days, 14 August 2019 and 4 September 2019. During the inspection on 14 August 2019 we spoke with one of the practice owners who is a registered dentist and mainly conducts facial aesthetic treatments at the practice but also completes general dentistry occasionally if required. The principal dentist was not available during this inspection. We also spoke with one dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed. There were no dental patients at the practice during this inspection. This inspection continued on 4 September 2019 to enable us to speak with the principal dentist and review documentation that was not available at the inspection of 14 August 2019.
The practice is open: Monday to Friday from 9am to 5.15pm.
Our key findings were:
- The practice appeared clean and well maintained.
- The provider’s infection control procedures were developed prior to the implementation of HTM 01-05; there was no written information about clinical waste. A separate waste segregation policy was developed at the practice during the inspection period.
- Staff knew how to deal with medical emergencies. Staff were not able to locate all appropriate medicines and life-saving equipment but these were purchased and delivered during our first visit.
- The provider’s systems to help them manage risk to patients and staff required improvement. Issues identified were addressed during the inspection period.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- Support was provided by an external company regarding staff recruitment procedures. Not all information identified in Schedule three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was available in staff recruitment files. This was addressed during this inspection period. There was no evidence of appropriate recruitment procedures being followed for one member of staff who no longer worked at the practice.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- Staff provided preventive care and supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- Staff felt involved and supported and worked well as a team.
- The provider had some systems to ask staff and patients for feedback about the services they provided although improvements were required.
- The provider had not received any complaints but had systems in place to deal with complaints positively and efficiently.
- Improvements were required to information governance arrangements.
We identified regulations the provider was not complying with. They must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
Full details of the regulations the provider is not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
- Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
- Develop systems to ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff. Including the training, learning and development needs of individual staff members at appropriate intervals.