Great Northern Road Dental Clinic

We carried out this announced comprehensive inspection on 11 December 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:

• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Improvements were needed to ensure patients’ personal information was stored securely.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs and 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.
• Complaints were dealt with positively and efficiently.
• The dental clinic appeared generally clean yet there were areas where cleanliness could be improved for example some drawers and cupboards.
• The practice infection control procedures did not reflect published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were generally available.
• The practice did not have systems to manage risks for patients, staff, equipment and the premises.
• Safeguarding processes were generally in place however improvements were needed.
• The practice did not have suitable recruitment procedures which reflected current legislation.
• There was ineffective leadership and a lack of oversight of the day-to-day management of the service.
• There were ineffective systems to support continuous improvement.
• Patients were not asked for feedback about the services provided.
• The practice did not have good information governance arrangements.

Background

Great Northern Road Dental Clinic is in Dunstable and provides NHS and private dental care and treatment for adults and children.

There is step free access to the practice for people who use wheelchairs and those with pushchairs with the use of a ramp. Car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 4 dentists, 1 orthodontist, 4 dental nurses, 1 trainee dental nurse, 2 dental hygienists, 1 practice manager and 2 receptionists. The practice has 5 treatment rooms.

During the inspection we spoke with 2 dentists, 3 dental nurses and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday – Friday 9am until 5.30pm.

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.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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

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

• Take action to implement any recommendations in the practice's Legionella risk assessment, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’
• Implement protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office in particular a Data Protection Impact Assessment.
• Take action to ensure audits of antimicrobial prescribing are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.