Pearce & Nobles @ Sawley Dental

We carried out this announced focussed inspection 5 October 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 asked the following three questions:

• 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:

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 well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Pearce & Nobles @ Sawley Dental is between Nottingham and Derby close to junction 25 of the M1 motorway and provides NHS and private dental care and treatment for adults and children.

Car parking spaces, including dedicated parking for people with disabilities, are available near the practice.

The dental team includes four dentists, two dental hygiene therapists, one dental hygienist, six dental nurses including one trainee, the dental nurses also work on reception, two receptionists, and a practice manager. The practice has four treatment rooms, none of which are located on the ground floor.

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 about how the practice is run.

During the inspection we spoke with dentists, dental nurses and receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Wednesday: 9am to 7pm

Thursday to Friday: 9am to 5:30pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The provider had systems to help them manage risk to patients and staff.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• An external company had completed a Legionella risk assessment in August 2016. However, improvements could be made to reduce the risk of Legionella, through regular checking and recording of hot and cold water temperatures.
• The provider had staff recruitment procedures which reflected current legislation.
• The practice did not have individual risk assessments for items covered by the Control of Substances Hazardous to Health (COSHH) regulations.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Antimicrobial prescribing audits were not being completed in line with the College of General Dentistry guidelines.
• Staff provided preventive care and supported patients to ensure better oral health.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.

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.’ In particular regular testing and recording of hot and cold-water temperatures to identify any increased risk relating to Legionella.

• Improve the practice's processes for the control of substances hazardous to health identified by the Control of Substances Hazardous to Health (COSHH) Regulations 2002, to ensure individual risk assessments are undertaken for all products.

• Review the practice protocols regarding audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.

• Improve the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular the systems for checking the emergency medicines and equipment.