Updated 10 February 2022
We carried out this announced focused inspection on 1 February 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 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 three questions:
• 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 practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider had systems to help them manage risk to patients and staff. The risks associated with Legionella and tracking of prescriptions requires review.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which reflected current legislation.
- 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 supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with any complaints positively and efficiently.
- The provider had information governance arrangements.
Background
T & T Dental is in North Liverpool and provides NHS and some private dental care and treatment for adults and children.
There is level access to the practice for people who use wheelchairs and those with pushchairs via a ramp. Car parking spaces are available in residential roads near the practice.
The dental team includes two dentists, and three dental nurses, one of whom is a trainee. The practice has three treatment rooms, one at ground floor level and the other two at first floor level.
During the inspection we spoke with both 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 from Monday to Wednesday from 9am to 5.30pm and on Thursday and Friday from 9am to 5.00pm.
There were areas where the provider could make improvements. They should:
- Review the scope of the current Legionella risk assessment 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.’ In particular that the hot water cylinder on the premises, which is working and for use in emergencies, is considered in the current Legionella risk assessment and that appropriate mitigations are in place as required.
- Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
- Improve the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term. In particular, that policies, for example the practice whistleblowing policy is updated to include all contact details for relevant organisations.