Updated 10 January 2020
We undertook a follow-up inspection of Milk Dental on 10 December 2019. This inspection was carried out to review in detail the actions taken by the provider to improve the quality of care, and to confirm whether the practice was now meeting legal requirements.
The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
We undertook a comprehensive inspection of Milk Dental on 13 February 2019 under section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. At a comprehensive inspection we always ask the following five questions to get to the heart of patients’ experiences of care and treatment:
• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive?
• Is it well-led?
We found the provider was not providing safe and well-led care and was in breach of regulations 12,17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Milk Dental on our website www.cqc.org.uk.
When one or more of the five questions are not met we require the provider to make improvements. We then inspect again after a reasonable interval, focusing on the areas in which improvement was necessary.
We undertook a follow-up inspection of Milk Dental on 5 April 2019 to review in detail the actions taken by the provider to improve the quality of care, and to confirm whether the practice was meeting the legal requirements. We focused on the requirements of regulations 12 and 19.
During the inspection we found the provider had not acted sufficiently to ensure compliance with these regulations. We also identified additional risks. We took urgent action to ensure people could not be exposed to a risk of harm and suspended the provider’s CQC registration for a period of three months to allow the provider to act on the risks. You can read our report of the
inspection by selecting the 'all reports' link for Milk Dental on our website www.cqc.org.uk.
We undertook a further follow-up inspection of Milk Dental on 9 July 2019 to review in detail the actions taken by the provider to improve the quality of care. We focused on the risks outlined in our suspension notice. We found the provider had acted sufficiently by the date of expiry of the suspension notice. You can read our report of the inspection by selecting the 'all reports' link for Milk Dental on our website www.cqc.org.uk.
As part of this follow-up inspection on 10 December 2019 we asked:
• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?
We also checked whether the provider was now meeting the requirements of regulation 17.
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 caring?
We found this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found this practice was providing responsive 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.
We also found that the provider had made improvements in relation to the regulatory breach we identified at our inspection on 13 February 2019.
Background
Milk Dental is in a residential suburb of Liverpool and provides NHS and private dental care for adults and children.
Car parking spaces are available near the practice.
The dental team includes a principal dentist and a dental nurse. The practice has two 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.
During the inspection we spoke to the principal dentist. We looked at practice policies and procedures, and other records about how the service is managed.
The practice is open:
Monday to Friday: 9.00am to 5.00pm.
Our key findings were:
- The practice was visibly clean.
- The practice had infection control procedures in place which reflected published guidance.
- The provider had safeguarding procedures in place.
- Appropriate medicines and equipment were available for responding to medical emergencies.
- The provider had staff recruitment procedures in place.
- The dentist provided preventive care and supported patients to achieve better oral health.
- The practice treated patients with dignity and respect and took care to protect their privacy and personal information.
- The appointment system took account of patients’ needs.
- The provider had a procedure in place for handling complaints.
- The provider had systems in place to manage risk. No provision had been made for reviewing risks at the practice. Insufficient measures had been put in place in relation to other risks.
- The provider had systems to support the management and delivery of the service, to support governance and to guide staff.
- The practice asked patients and staff for feedback about the services they provided.
There were areas where the provider could make improvements. They should:
- Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities.
- Take action to ensure that all clinical staff have adequate immunity against vaccine-preventable infectious diseases.
- Take action to ensure the guidelines issued by the British Society of Periodontology are taken into account.
- Take action to ensure the practice’s arrangements for good governance and leadership are sustained in the longer term.
We are continuing to liaise with our colleagues at NHS England in monitoring and supporting the provider.