Archived: Diamond Dental of Harley Street

We undertook a follow up focused inspection of Diamond Dental of Harley Street

on 11 September 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Diamond Dental of Harley Street on 7 May 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe or well led care and was in breach of regulations 12 safe care and treatment, 17 good governance and 18 staffing and 19 fit and proper person employed of the Health and Social Care Act 2008, Regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Diamond Dental of Harley Street on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it safe?

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements.

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 7 May 2019.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 7 May 2019.

Background

Diamond Dental of Harley Street is in the London Borough of Westminster the practice provides private treatments to patients of all ages.

The dental team includes the dentist who owns the practice and a dental nurse.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Diamond Dental of Harley Street is the principal dentist.

During the inspection we spoke with the dentist. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The provider had improved the practice infection control procedures so that they generally reflected published guidance. However, some further improvements were required.
• The provider had a staff recruitment procedure in place.
• The provider had suitable safeguarding processes and the principal dentist had received safeguarding training and knew their responsibilities for safeguarding vulnerable adults and children.
• The dentist and dental nurse had undertaken appropriate training including safeguarding and infection control.
• There were arrangements to ensure that the premises and equipment were fit for use. Although the five year electrical test had still not been undertaken.
• The provider had systems in place to audit their clinical processes.

The practice had also made the following improvements :

• The practice had protocols to ensure that patient referrals were monitored suitably.
• The provider had complaint handling procedures and had establish an accessible system for identifying, receiving, recording, handling and responding to complaints by service users. This included a complaints procedure.

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

• improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ .

• Take action to ensure the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular to carry out a five year electrical test at the service.

We carried out this announced inspection on 7 May 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 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 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 not 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

Diamond Dental of Harley Street is in the City of Westminster in London and provides NHS and private treatment to adults and children.

Car parking spaces, including some for blue badge holders, are available near the practice.

The dental team includes a dentist and a dental nurse. The practice has one treatment room that incorporates a decontamination area.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Diamond Dental of Harley Street is the principal dentist.

On the day of inspection, we collected 17 CQC comment cards filled in by patients. There were no patients to speak with on the day of the inspection.

During the inspection we spoke both with the dentist and the dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice appeared clean and well maintained.
• 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 were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider asked staff and patients for feedback about the services they provided.
• Staff knew how to deal with medical emergencies. Medicines and life-saving equipment were available on the premises.
• Improvements were required to the provider’s infection control procedures.
• The practice had not established effective systems to help them manage risk to patients and staff.
• The dentist was not up to date with key training such as safeguarding children and vulnerable adults, infection prevention and control and radiography.
• The provider did not have a staff recruitment procedure in place.
• The provider did not have systems in place to audit their non-clinical and clinical processes.

We identified regulations the provider was 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.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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:

• Review the provider’s protocols for referral of patients and ensure all referrals are monitored suitably.

• Review its complaint handling procedures and establish an accessible system for identifying, receiving, recording, handling and responding to complaints by service users.