High Street Dental Practice

We carried out this announced focused inspection on 23 March 2023 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 practice 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 5 key questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive?
• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic was visibly clean and well-maintained.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff felt involved and supported and worked well as a team.
• The dental clinic had appropriate information governance arrangements in place.
• Appropriate pre-employment references and Disclosure and Barring Service (DBS) checks had not always been obtained for new staff.
• Patient dental care records did not meet standards set by the College of General Dentistry.
• Risk assessment was not effective, and recommendations from the practice’s Legionella, and Health and Safety assessments had not been implemented by staff.
• Overall governance systems in the practice needed to strengthen to ensure a safe service was provided to patients.

Background

High Street Practice provides both NHS funded and private dental care and treatment for adults and children. The practice is accessible for wheelchair users although the toilet is not accessible and there is no dedicated parking for patients on site. There are 2 treatment rooms.

The dental team includes1 dentist, 2 trainee dental nurses, a practice manager and a receptionist who works off-site.

During the inspection we spoke with the dentist, both nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open on Mondays from 9am to 5pm, and on Wednesdays from 10am to 7pm.

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 was not meeting are at the end of this report.

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

• Implement an effective system of checks of medical emergency equipment and medicines taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.

• Improve and develop staff awareness of the requirements of the Mental Capacity Act 2005 and Gillick competency as it relates to their role.

• Take action to implement any recommendations in the practice's fire safety risk assessment, and ensure ongoing fire safety management is effective.

• Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices.