Archived: Cheshire Dental Centre

We carried out this announced inspection on 30 January 2020 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 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

Cheshire Dental Centre is near the centre of Crewe. The practice provides NHS and private dental care for adults and children.

There is level access to the practice for people who use wheelchairs and for people with pushchairs. The provider had installed a ramp to facilitate access to the practice for wheelchairs and pushchairs.

Car parking is available outside the practice.

The dental team includes three dentists, a dental hygiene therapist, and four dental nurses, one of whom is a trainee. The dental team is supported by a practice manager. The practice has three treatment rooms.

The practice is owned by an individual who is the main partner 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.

On the day of the inspection, we collected 15 CQC comment cards filled in by patients.

During the inspection we spoke to the principal dentist, dental nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 10.30am to 7.00pm

Tuesday and Thursday 9.00am to 5.30pm

Wednesday 11.00am to 8.00pm

Friday 9.00am to 4.00pm.

Our key findings were:

• The practice was visibly clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• The provider had safeguarding procedures in place and staff knew their responsibilities for safeguarding adults and children.
• Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available.
• The provider had staff recruitment procedures in place. These did not reflect the relevant legal requirements.
• Staff provided patients’ care and treatment in line with current guidelines but did not take into account all recognised guidance.
• The dental team provided preventive care and supported patients to achieve better oral health.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took account of patients’ needs.
• The provider had a procedure in place for handling complaints. The practice dealt with complaints positively and efficiently.
• The practice had a leadership and management structure.
• The provider had systems in place to manage risk. These were not all operating effectively.
• Staff felt involved and supported and worked as a team.
• The provider had systems to support the management and delivery of the service, to support governance and to guide staff. These were not all operating effectively.

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
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• Ensure specified information is available regarding each person employed

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

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 in relation to flushing of little-used outlets.
• Take action to ensure the clinicians carry out orthodontic patient assessments in sufficient detail and ensure they take into account relevant nationally recognised evidence-based guidance.
• Improve and develop 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.
• Review the practice’s protocols in relation to the use of closed-circuit television to ensure patients are fully informed as to its purpose and their right to access footage taking into account the guidelines published by the Information Commissioner's Office.