Leather Lane Dental Practice

We undertook a follow up desk-based review of Leather Lane Dental Practice on 17 July 2020. This review was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The review was carried out by a CQC inspector who had remote access to a specialist dental adviser.

We undertook a comprehensive inspection of Leather Lane Dental Practice on 23 January 2020 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Leather Lane Dental Practice on our website www.cqc.org.uk.

As part of this review we asked: Remove as appropriate:

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breach we found at our inspection on 23 January 2020.­­

Background

Leather Lane Dental Practice is in Holborn in the London Borough of Camden and provides private dental care and treatment for adults and children.

The practice is located close to public transport links and has three treatment rooms all located on the first floor.

The dental team includes six dentists, one dental nurse, one trainee dental nurse, two dental hygienists and one receptionist.

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.

The practice is open between :

9am and 5pm on Mondays

7.30am and 7pm on Tuesdays to Thursdays

8.30am and 4.30pm on Fridays

Our key findings were:

• Systems were in place to monitor the expiry dates of dental materials on a monthly basis.
• All medical emergency equipment and medicines were stored correctly and in date, and systems had been implemented to ensure regular ongoing monitoring.
• There were systems in place to monitor patient referrals to ensure that patients were seen in a timely manner and followed up where needed.
• The practice had registered to receive patient safety alerts so as to review and manage any risks arising from this information.
• Risks assessments had been carried out relating to the maintenance of equipment, domiciliary care, staff lone working, and hazardous substances
• Policies and procedures in relation information governance, General Data Protection Regulations and the use of Closed Circuit TV were updated and were available.

The provider had also made further improvements:

• The practice had systems for auditing patient dental care records to check that necessary information is recorded
• Action had been taken to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.

We carried out this announced inspection on 23 January 2020 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 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:

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 caring?

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

Are services responsive?

We found this practice was providing responsive 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

Leather Lane Dental Practice is in Holborn in the London Borough of Camden and provides private dental care and treatment for adults and children.

The practice is located close to public transport links. The practice has three treatment rooms all located on the first floor.

The dental team includes six dentists, one dental nurse, one trainee dental nurse, two dental hygienists and one receptionist.

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.

On the day of inspection, we collected feedback from 17 patients including patients we spoke with on the day,

During the inspection we spoke with two dentists, one dental nurse, one trainee dental nurse, one dental hygienist and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between :

9am and 5pm on Mondays

7.30am and 7.00pm on Tuesdays to Thursdays

8.30am and 4.30pm on Fridays

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available; however, improvements were needed to ensure medicines were stored and maintained in accordance with current guidelines.
• The provider had some systems to help them manage risk to patients and staff; however improvements were needed to consider all risks.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had infection control procedures which reflected published guidance.
• The practice had arrangements for the safe use of medicines and equipment. Improvements were needed to ensure out of date materials were disposed of appropriately.
• The provider had staff recruitment procedures which reflected current legislation, however improvements were needed to include checks for temporary members of staff.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• There was ineffective leadership and a lack of general oversight for the day-to-day running of the service.
• 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 some information governance arrangements, however this needed to be updated to reflect current General Data Protection Regulations requirements.

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.

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

• Review the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
• Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.