Updated 19 May 2022
We carried out this announced focused inspection on 13 April 2022 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 usually ask five key questions, however due to the ongoing COVID-19 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 questions form the framework for the areas we look at during the inspection.
Our findings were:
- The practice had infection control procedures which reflected published guidance.
- The practice had systems to help them manage risk to patients and staff.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice had staff recruitment procedures which reflected current legislation.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- Staff knew how to deal with medical emergencies. Improvements were needed to the protocols to ensure emergency equipment and medicines were available as described in the Resuscitation Council UK 2021 guidelines.
- The dental clinic had information governance arrangements; however, improvements were needed in relation to the use of closed-circuit television (CCTV).
- Improvements were needed to the protocols for managing and dispensing medicines.
- The dental clinic was visibly clean and well-maintained; however, improvements were needed to the storage arrangements of the cleaning equipment.
Background
The provider has two practices and this report is about Strictly Dental Limited .
The practice is in Carlisle in Cumbria and provides NHS and private dental care and treatment for adults and children.
There is level access to the practice via a removable ramp for people who use wheelchairs and those with pushchairs. The practice is located close to local transport links and car parking spaces, are available near the practice. The practice has made reasonable adjustments to support patients with additional needs, for example the availability of a hearing induction loop and handrails.
The dental team includes four dentists, seven dental nurses, one trainee dental nurse, three dental hygienists, one dental therapists, two receptionists and the practice manager. The practice has five treatment rooms.
The practice manager could not be available on the day of the inspection. We carried out a video call with them and discussed practice protocols and procedures. During the inspection we spoke with three dentists, three dental nurses and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Mondays and Thursdays from 9am to 6pm
Tuesdays and Wednesdays from 9am to 5pm
Fridays from 9am to 4pm
There were areas where the provider could make improvements. They should:
- Implement protocols for the use of closed-circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.
- Take action to ensure the availability of medicines in the practice to manage medical emergencies taking into account the guidelines issued by the British National Formulary and the General Dental Council. Review the practice's protocols for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
- Improve the practice's systems for checking and monitoring equipment, including X-ray equipment taking into account relevant guidance and ensure that all equipment is well maintained. In particular in relation to the ultrasonic bath and the suction motor.
- Take action to improve audits to ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.