Shelton Dental Centre

We carried out this announced comprehensive inspection on 7 February 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.
• The practice had infection control procedures which reflected published guidance. We found these were not always followed or applied effectively.
• Staff knew how to deal with medical emergencies. However, we were unable to identify whether some of the emergency medical equipment seen had passed its expiry date. Following this inspection, we were informed that replacement equipment had been ordered.
• The practice’s systems to manage risks for patients, staff, equipment and the premises were not effective or embedded.
• 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.
• Clinical staff did not always evidence they 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.
• Leadership was not always effective and evidence of a culture of continuous improvement was not observed
• Staff and patients were asked for feedback about the services provided. Although practice meetings were held infrequently.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.

Background

Shelton Dental Care is in Shelton, Stoke on Trent 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. Car parking spaces, including dedicated parking for disabled people, are available in pay and display car parks near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 7 dentists, 14 dental nurses (including 5 trainee dental nurses), 3 receptionists, 2 cleaners and a laboratory technician. The practice has 12 treatment rooms.

During the inspection we spoke with 4 dentists (practice partners), 2 dental nurses, 2 receptionists. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open: Monday to Friday from 8.30am to 5pm.

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation/s 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 ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records and are aware of the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.

• Improve and develop the practice's policies and procedures for obtaining patient consent to care and treatment to ensure they are in compliance with legislation, take into account relevant guidance, and staff follow them.

• Take action to ensure that orthodontists carry out a patient assessment in line with recognised guidance from the British Orthodontic Society and that an Index of Orthodontic Treatment Need are recorded at the end of NHS orthodontic treatments.