The Rickmansworth Dental Centre

We carried out this announced comprehensive inspection on 8 August 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 advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:

• The dental clinic appeared clean and well-maintained.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which mostly reflected current legislation.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.
• Staff knew how to deal with medical emergencies. Appropriate medicines and most life-saving equipment were available.
• Some of the practice’s infection control procedures did not reflect published guidance.
• The practice had limited systems to help them manage risk to patients and staff. There were shortfalls in the assessment and mitigation of risks in relation to fire, legionella, lone working, the Control of Substances Hazardous to Health and management of medical emergencies

Background

Rickmansworth Dental Centre is in Rickmansworth, Hertfordshire and provides NHS and private dental care and treatment for adults and children.

There is a step into the practice reception area with a flight of stairs leading to the treatment rooms. A stairlift is available for people who have mobility difficulties. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes a dentist, a trainee dental nurse, 2 dental hygienists and a receptionist. The practice has 2 treatment rooms.

During the inspection we spoke with the dentist, the trainee dental nurse and the receptionist. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday, Tuesday, Wednesday, Thursday from 8.30am to 5.30pm

Friday from 8am to 1pm

Saturday (1 per month) from 9am to 1pm.

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.

Full details of the regulations the provider is not meeting are at the end of this report.

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

• Improve the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff. In particular, satisfactory evidence of conduct in previous employment (references).

• Improve the practice’s systems for environmental cleaning taking into account current national specifications for cleanliness in the NHS.

• Take action to ensure dentists are aware of the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.

• Take action to ensure audits of record keeping, and antimicrobial prescribing 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.