Ilford Dental Practice

We carried out this announced inspection on 10 June 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.

To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These are three of the five questions that form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

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

Are services effective?

We found this practice was not providing effective 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

Ilford Dental Practice is in the London Borough of Redbridge and provides private dental treatment to adults and children. The practice is accessible by Transport for London rail and bus services and is within easy access to local amenities including banks, supermarkets and a post office. The practice is not suitable for people who are in wheelchairs as there is no lift on the premise to access treatment rooms on the first floor. Paid parking spaces are available near the practice.

The practice is located on the first floor of the building which is accessed using two flights of stairs. The first floor has four treatment rooms (two viable-one functional), a treatment room which is now the decontamination room, an office area used for storage, a toilet, reception area and a waiting area.

The practice is owned by an individual who is the principal and only dentist there and is supported by two GDC registered dental nurses- one of whom serves as the reception staff and was furloughed at the time of our inspection. The principal dentist who is the responsible individual has a 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 Monday to Friday from 10:00am to 3pm. When the practice is closed, out of hours services are provided by the NHS 111 services. They did not have a website at the time of the inspection.

During the inspection we spoke with the principal dentist and the dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice needed redecoration, refurnishing and general refurbishment.
• There was inadequate arrangements in place to monitor staff training.
• The treatment room which was used to deliver care and treatment appeared visibly clean.
• Improvements were needed in relation to infection prevention and control and fire safety.
• Not all risks to service users were appropriately assessed and managed.
• The practice had some policies and procedures to govern activities, however some were not current.
• Clinical waste was not disposed suitably.
• Equipment such as the autoclave, ultrasonic bath, dental chair, suction and compressor had not been serviced as per manufacturer’s guidance.
• There were ineffective arrangements to assess and mitigate risks of fire at the practice.
• The practice did not have suitable arrangements to ensure safety of the X-ray equipment.
• Emergency equipment and medicines were not available as described in recognised guidance.
• The practice did not have systems to keep dental professionals up to date with current evidence-based practice.
• Dental care records we checked were not completed as per recommended guidance and were stored insecurely.
• The team was qualified to undertake their roles; however, they had limited systems to ensure they kept up to date with emerging guidance.
• The dental team was long-standing which meant there was continuity of care and treatment for patients.

We identified regulations the provider was not complying with. They must:

• Ensure care and treatment is provided in a safe way to patients.
• 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:

• Improve the decoration and overall aesthetic of the premise.
• Take action to improve the system for sending electronic referrals.

The CQC have received formal notification from the provider- Mr Ananatkumar Patel that they have ceased the delivery of all regulated activities from the registered location as of 15 June 2021. The location will remain closed for a period of four weeks whilst the provider takes steps to rectify the concerns raised during the inspection of 10 June 2021. The Commission will review the improvements at a follow up inspection.