Sidwell Dental Surgery

We carried out this announced comprehensive inspection on 17 May 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.
• Staff knew how to deal with medical emergencies. Appropriate medicines were available.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. Staff should complete safeguarding training updates at least every 3 years.
• Clinical staff 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.
• Staff worked well as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.
• Improvements are required to ensure the effectiveness of infection control procedures and processes, including the Control of Substances Hazardous to Health (COSHH).
• Improvements are required to effectively maintain equipment used in the premises.
• Improvements are required to manage stock control, to ensure items do not exceed manufacturer’s use-by dates.
• The culture at the practice is patient focused and the providers demonstrated an open and willing attitude to ensure issues identified will be addressed.

Background

Sidwell Dental Surgery is in Exeter and provides NHS dental care and treatment for adults and children. A small amount of private dentistry is also provided.

The surgery is on the first floor, accessed either by stairs or a passenger lift. However, the practice is not fully accessible due to limitations with the size of bathrooms. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 1 dentist and 1 dental hygienist, who provide chairside support for one another. The practice has 1 treatment room.

During the inspection we spoke with the dentist and dental hygienist. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open: Monday to Friday 9.00am – 1.00pm. 2.00pm – 5:30pm.

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

• Systems or processes must be established and operated effectively to ensure compliance with the requirements of the fundamental standards as set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Full details of the regulation the provider is not meeting are at the end of this report.

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

• Implement an effective system 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.
• Take action to ensure that all the staff have received updates in training, to an appropriate level, in the safeguarding of children and vulnerable adults at least three yearly.
• Improve and develop staff awareness of autism and learning disabilities and ensure all staff receive appropriate training in this.
• Implement audits for prescribing of antibiotic medicines, taking into account the guidance provided by the College of General Dentistry.
• Take action to ensure the service takes into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010, by reviewing the disability access audit.