Ashley Down Dental Care

We carried out this announced focused inspection on 30 June 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 five 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 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

Ashley Down Dental Care is in Horfield, Bristol and provides NHS and private dental care and treatment for adults and children.

The treatment rooms are situated on the first and second floor of the practice and only accessible via stairs. The practice is unable to accommodate people who use wheelchairs. There is car parking available near the practice.

The dental team includes four dentists, two qualified dental nurses, two trainee dental nurses, one dental hygienist, practice manager, finance manager and three receptionists. The practice has four treatment rooms (three of which are currently in use).

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 three dentists including the principal dentist, two qualified dental nurses, two receptionists 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 8:30am to 6pm
• Tuesday 8:30am to 6pm
• Wednesday 8:30am to 5:30pm
• Thursday 8:30am to 5:30pm
• Friday 8:30am to 1pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider’s infection control protocols reflected published guidance; some improvements were however needed.
• 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, which could be improved. For example, undertaking an appropriate fire risk assessment to ensure relevant fire risks had been mitigated.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures that reflected current legislation. These were not always followed when staff were recruited.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff provided preventive care and supported patients to ensure better oral health.
• Staff felt involved and supported and worked as a team.
• Staff training was not always monitored to ensure staff were effectively supported to complete their continuing professional development and mandatory training.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had information governance arrangements that reflected current guidance.

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 is not meeting is at the end of this report.

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

• Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• 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. In particular, ensuring a risk assessment to mitigate any risks is undertaken for clinical staff working on their own.
• Take action to ensure the clinicians take into account guidelines when prescribing antibiotics and implement a full antibiotic prescribing audit taking into account the Faculty of General Dental Practice guidelines.