Updated 26 April 2022
We carried out this announced focused inspection on 6 April 2022 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 adviser.
To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:
• 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:
- The dental clinic appeared to be visibly clean and well-maintained.
- The practice had infection control procedures which reflected published guidance.
- 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.
- Staff knew how to deal with medical emergencies. Most appropriate medicines and life-saving equipment were available, except for the medicine to manage a seizure and an automated external defibrillator (AED). These were ordered immediately after the inspection.
- The practice had systems to help them manage risk to patients and staff although there were shortfalls in the security of prescriptions and management of risks associated with the Control of Substances Hazardous to Health.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- The dental clinic had information governance arrangements.
Background
The provider has two practices and this report is about Cherry Tree Dental Care.
Cherry Tree Dental Care is in Cheshunt, Hertfordshire and provides NHS and private dental care and treatment for adults and children.
There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice. The practice has made some adjustments to support patients with additional needs.
The dental team includes three dentists, two dental nurses, one dental hygienist, two receptionists and a practice manager. The practice has three treatment rooms.
During the inspection we spoke with one dentist, two dental nurses, one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Mondays, Tuesdays, Wednesdays and Thursdays from 9am to 5.30pm
Fridays from 8am to 2pm
Saturdays from 8am to 1pm
There were areas where the provider could make improvements. They should:
Take action to ensure the availability of medicines and equipment in the practice. In particular, the medicine to manage a seizure and an automated external defibrillator (AED) is available immediately to manage medical emergencies, taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
Improve the security of NHS prescription pads in the practice and ensure scripts are not pre-stamped and there are systems in place to identify lost or missing scripts.
Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
Take action to ensure audits of radiography are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
Improve the practice's processes for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken for all cleaning products used in the practice.