Longlands Dental Practice

We carried out this announced focused inspection on 30 March 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 emergencies. Appropriate medicines and life-saving equipment were available. However, we found one item was out of date and one medicine had been stored outside refrigeration and the expiry date had not been adjusted to accommodate this. The out of date equipment was ordered immediately after the inspection and the shelf life of the medicine was adjusted.
• The practice had some systems to help them manage risk to patients and staff but there were shortfalls in the assessment and mitigation of risks in relation to recruitment, the control of substances hazardous to health, medical emergency equipment, maintenance of equipment, and lone working.
• The five yearly electrical fixed wire testing had not been undertaken.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which did not reflect current legislation as the provider was not currently seeking evidence of satisfactory conduct in previous employment (references) for newly appointed staff.
• 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.

Background

The provider has one practice and this report is about Longlands Dental Practice.

Longlands Dental Practice is in Hemel Hempstead and provides NHS and 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. Car parking spaces are available in a car park at the front of the practice. The practice has made some adjustments to support patients with additional needs.

The dental team includes four dentists, four dental nurses including one trainee dental nurse, one dental hygienist, and a practice manager. The dental nurses also work on reception. The practice has three treatment rooms.

During the inspection we spoke with three dentists, two dental nurses, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 9am to 5pm.

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 regulation the provider was not meeting are at the end of this report.

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

• Take action to ensure audits of antimicrobial prescribing are undertaken at regular intervals to improve the quality of the service and that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

• Take action to ensure all clinicians are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.