Far Cotton Dental Practice

We carried out this announced inspection on 21 October 2021 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 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:

Are services safe?

We found this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Far Cotton Dental Practice is in Northampton 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. The reception and waiting areas are up a steep flight of stairs. The practice is located on a busy high road so is unable to provide car parking spaces. The practice did not have access to a hearing loop for people experiencing hearing difficulties.

The dental team includes one dentist, a practice manager and two dental nurses, one of whom also works as the receptionist. The practice has two 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 spoke with one dentist, 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 9am to 6pm

Tuesday, Wednesday, Thursday 9am to 5.30pm

Friday 9am to 2pm

Our key 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 providers systems were not effective in helping to identify and mitigate against manage risk to patients and staff. Sharps and safety of patients airways were not managed safely. The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. The safeguarding lead was unable to evidence that they had completed safeguarding training on the day of our inspection.
• The provider had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines. Records did not always contain sufficient detail to support this.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Preventive care and advice was not always recorded in patients dental care records to support better oral health.
• The provider did not always demonstrate 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 complaints positively and efficiently.
• The provider had information governance arrangements.

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

• Improve the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities.

• Improve the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term.

Full details of the regulation/s the provider was/is not meeting are at the end of this report.

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

• Take action to ensure dentist is aware of the guidelines issued by the British Endodontic Society for the use of rubber dam or other airway protection for root canal treatment .Improve the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.