Updated 8 October 2021
We carried out this announced inspection on 7 September 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.
As part of this inspection we asked;
• 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 providing well-led care in accordance with the relevant regulations.
Background
S I Mckenzie & Associates is in Colchester, Essex 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. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice.
The dental team includes three dentists, two hygienists, six dental nurses (four of whom also covered reception duties), two trainee dental nurses, the practice manager, the deputy practice manager (who was a qualified dental nurse) and one receptionist. The practice has four 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 two dentists, four dental nurses (three of which cover reception duties), two trainee dental nurses, the practice manager and the deputy practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open: Monday to Friday from 9am to 5.30pm, Saturday from 9am to 1pm.
Our key findings were:
- Premises and equipment were clean and properly maintained and the practice followed national guidance for cleaning, sterilising and storing dental instruments. However, we noted five-yearly electrical fixed wire testing had not been completed.
- The provider had infection control procedures which reflected published guidance.
- The provider confirmed that infection prevention and control audits had not been undertaken as frequently during the previous 18 months. During the inspection we were assured these would be undertaken bi-annually going forward.
- 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.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which reflected current legislation.
- 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.
- The provider had 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.
There were areas where the provider could make improvements. They should:
- Take action to ensure the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular ensure the five-yearly electrical fixed wire testing is undertaken.
- Take action to ensure audits infection prevention and control are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.