Hillside Dentalcare

We carried out this announced comprehensive inspection on 19 September 2023 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 advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:

• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• Staff felt involved and supported.
• Staff and patients were asked for feedback about the services provided.
• The dental clinic appeared generally clean. However, work surfaces in the clinical area and the decontamination room were cluttered and not impervious.
• The practice infection control procedures did not reflect published guidance.
• Appropriate medicines and life-saving equipment were not available. Not all members of staff had completed training in emergency resuscitation and basic life support.
• The practice did not have effective systems to manage risks for patients, staff, equipment and the premises.
• There were ineffective processes in place to prevent abuse of vulnerable adults and children.
• The practice did not have suitable recruitment procedures to comply with current legislation.
• Improvements were needed to clinical staff`s understanding of the current clinical guidelines.
• Improvements were needed to ensure patient care records were complete and included adequate details of the care provided.
• There was ineffective leadership and systems in place to support continuous improvement were not effective.
• The practice did not have effective complaints procedures in place.
• Patients were treated with dignity and respect. Improvements were needed to ensure patient care records were stored securely.
• The practice did not have suitable information governance arrangements.

Background

Hillside Dentalcare is in the London Borough of Hillingdon and provides NHS and private dental care and treatment for adults and children.

There is step free access to the practice for people who use wheelchairs and those with pushchairs. The practice does not have an accessible toilet and they communicated this to new patients before booking. Car parking spaces are available near the practice.

The dental team includes the principal dentist, 2 associate dentists, 1 qualified dental nurse, 2 trainee dental nurses and 1 dental hygienist. The practice has 1 treatment room.

During the inspection we spoke with the principal dentist and one of the trainee dental nurses. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday, Tuesday, Thursday and Friday from 8.30am to 5.30pm

Wednesday from 8.30am to 4.30pm

Saturdays by appointment only.

We identified regulations the provider was not complying with. They must:

• Ensure care and treatment is provided in a safe way to patients.
• Ensure patients are protected from abuse and improper treatment.
• 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 activities receive appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their 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:

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

• Implement a system to ensure patient referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner and not lost.

• Improve and develop staff awareness of autism and learning disabilities and ensure all staff receive appropriate training in this.