Bupa Dental Care Bishops Stortford

We undertook a follow up inspection of Bupa - Barrett House Dental Centre, on 17 January 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that 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 Bupa - Barrett House Dental Centre on 14 June 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. As a result of that inspection, we found the registered provider was not providing well led care and was in breach of regulation 17 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 Bupa - Barrett House Dental Centre on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

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

The provider had made improvements in relation to the regulatory breach we found at our inspection on 14 June 2018.

Background

Bupa - Barrett House Dental Centre is in Bishops Stortford and provides NHS and private treatment for adults and children.

There is level and stair lift access for people who use wheelchairs and those with pushchairs. Car parking spaces, including two for blue badge holders, are available outside the practice.

The dental team includes ten dentists, one specialist orthodontist, one endodontist, one oral surgeon and one periodontist, seven dental nurses (including two lead nurses), two trainee dental nurses, two dental hygienists, three receptionists, one practice coordinator and a practice manager. The practice has nine treatment rooms and two decontamination rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. At the time of inspection, the previous practice manager was still registered as the manager but had recently retired. A new practice manager was in post and the practice were in the process of nominating a new registered manager. A registered manager is legally responsible for the delivery of services for which the practice is registered.

During the inspection we spoke with the practice manager, the practice coordinator and the clinical support lead for the provider organisation. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday from 8am to 7pm.

Friday from 8am to 4pm.

Saturday from 9am to 1pm.

Our key findings were:

• There were effective systems and processes in place to ensure good governance in accordance with the fundamental standards of care.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Policies, protocols and safeguarding contact information had been reviewed and updated and was easily accessible to staff.
• Recruitment information was held at the practice and was in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• There were systems in place to ensure the security of NHS prescription pads in the practice and to track and monitor their use.
• Staff had undertaken training on the requirements of the Mental Capacity Act 2005 and were aware of their responsibilities under the Act and how it related to their role. In addition, staff were aware of Gillick competency and their responsibilities in relation to this.
• Staff had a clear awareness of the need for the practice to establish parental responsibility when seeking consent for children and young people.
• There were systems in place to ensure the secure storage of dental care records.

We carried out this announced inspection on 14 June 2018 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 CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five 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:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was not providing well-led care in accordance with the relevant regulations.

Background

Bupa-Barrett Lane is in Bishops Stortford and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including two for blue badge holders, are available near the practice.

The dental team includes ten dentists, one specialist Orthodontist, one oral surgeon, one lead nurse, seven dental nurses, two trainee dental nurses, two dental hygienists, three receptionists and one practice manager. The practice has nine treatment rooms and two decontamination rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Bupa-Barrett Lane was the practice manager.

On the day of inspection we collected 19 CQC comment cards filled in by patients.

During the inspection we spoke with five dentists, four dental nurses, one dental hygienist, two receptionists, the practice/registered manager and the provider company quality co-ordinator. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday from 8am to 7pm.

Friday from 8am to 4pm.

Saturday from 9am to 1pm.

Closed Sunday.

Our key findings were:

• The practice was clean and well maintained, and had infection control procedures that mostly reflected published guidance. We found the practice did not have records of bi-annual infection control audits.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had some systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Not all policies, protocols and safeguarding contact information was easily accessible to staff.
• We did not review recruitment information as we were told this was not held at the practice.
• 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.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• Staff felt involved and supported.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.

We identified regulations the provider was not meeting. They must:

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

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

• Review the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
• Review staff awareness of the requirements of the Mental Capacity Act 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role. In addition review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities in relation to this.
• Review staff awareness of the need for the practice to establish parental responsibility when seeking consent for children and young people.
• Review the practice's storage of dental care records to ensure they are stored securely.