14 September 2021
During an inspection looking at part of the service
We carried out this announced focused inspection on 14 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
Bushey Heath Dental Centre is in Bushey, Hertfordshire and provides NHS and private dental care and treatment for adults and children. As well as general dentistry it also provides dental implants. There is ramp access to the premises for wheelchair users and an accessible toilet.
The dental team includes seven dentists, with one dentist on the General Dental Council (GDC) specialist list for periodontics, and one dentist with a special interest in endodontics, one dental hygienist who also carries out a role as practice manager, five dental nurses, two of whom also undertake reception duties, 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, one hygienist, one dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday, Wednesday and Thursday from 8.30am to 5.15pm
Tuesday from 8.30am to 8pm
Friday from 8.30am to 4pm
Saturday from 8.30am 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.
- 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 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. However, we found that the policy had not always been followed, as not all staff records we reviewed had satisfactory evidence of conduct in previous employment (references).
- 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.
There were areas where the provider could make improvements. They should:
- Improve the practice's recruitment procedures to ensure accurate, complete and detailed records are maintained for all staff. In particular ensuring satisfactory evidence of employment (references) are included in all staff files.