Marble Arch Dental Centre

Updated 11 April 2017

This announced inspection was carried out on 27 October 2016 by two inspectors from the Care Quality Commission (CQC) and a GP specialist advisor. A second announced visit was made on 14 November 2016 by the lead inspector and a GP specialist advisor.

During the inspections we viewed the premises, spoke with the GPs, one dental nurse, and three receptionists. To assess the quality of care provided we looked at practice policies and protocols and other records relating to the management of the service, and inspected the premises.

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 caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 11 April 2017

We carried out an announced comprehensive inspection of the GP service at this location on 27 October and 14 November 2016 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

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

Are services effective?

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

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

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

Background

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. We have not inspected the GP service before.

Marble Arch Dental Centre provides NHS and private dental treatment to patients of all ages. It also provides an appointment based private GP service and an opticians.

The practice staffing consists of three principal dentists, 11 associate dentists, six qualified dental nurses, six trainee dental nurses, two hygienists and eight receptionist/administration staff. Two doctors provide the GP service.

One of the principal dentists is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run, including the GP service.

The GP service is provided from one consultation room. There is a main reception for both the dental and GP services, and a waiting area. The GP service is provided predominantly on Saturdays, and only by appointment.

During this visit we were unable to obtain the views of patients as none were available.

Our key findings were:

• The GPs were suitably qualified to meet the needs of patients.
• The consultation room used for the GP service was visibly clean and tidy.
• The service was accessible to patients who required non-emergency treatment and who were willing to pay private consultation fees.
• The registered provider had not ensured that all the specified information relating to persons employed at the service was obtained and appropriately recorded.
• The service had emergency equipment however it was not being regularly checked to ensure it functioned correctly. Emergency medicines were in place but not all were appropriately stored.
• Refrigerator temperatures were not being checked daily or recorded. We noted on our second visit that records of checks were now being kept and a second thermometer had been purchased.
• Patient records were incomplete in many cases, lacking adequate contact information.
• Staff employed in the dental and optician service would act as chaperones when required but not all had undergone a disclosure and barring service check. Both GPs told us that they had not, to date, seen a patient who had requested a chaperone.
• Governance systems were not effective. There were no systems to assess, monitor and improve the quality of the GP service or to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.

We identified regulations that were not being met and the provider must:

• Ensure equipment is regularly checked and calibrated where necessary.
• Ensure emergency medicines are appropriately stored.
• Ensure an effective system is established to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.
• Ensure the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• Ensure they maintain accurate, complete and contemporaneous records in respect of each service user.
• Ensure systems are in place to assess, monitor and improve the quality of the service.
• Ensure all staff who chaperone have undergone a disclosure and barring service check.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

• Review and update the practice’s safeguarding policy.
• Review the list of emergency medicines and amend stocked medicines where appropriate.
• Remove the unused medicines kept in the GP consultation room.