52 The Dental Practice

We carried out this announced inspection on 27 August 2021 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 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 always ask the following three questions:

• 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:

Are services safe?

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

Are services effective?

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

Are services well-led?

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

Background

52 The Dental Practice is in New Malden in the London Borough of Kingston-upon-Thames and provides private dental care and treatment for adults and children.

The practice is located close to public transport links and car parking spaces are available near the practice.

The dental team includes one dentist and one dental nurse/receptionist. The practice has one treatment room.

The practice is owned by a company and as a condition of registration must have a person registered with the CQC 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 52 The Dental Practice is the principal dentist.

During the inspection we spoke with the dentist and the dental nurse/receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Tuesday to Thursday 9:00am - 5:00pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had safeguarding processes in place and staff knew their responsibilities for safeguarding vulnerable adults and children. Improvements were however needed to ensure training was carried out regularly.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff provided preventive care and supported patients to ensure better oral health.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had information governance arrangements.
• Staff knew how to deal with emergencies and appropriate life-saving equipment was available. Improvements were needed to ensure all recommended emergency medicines were available.
• The provider had systems to help them manage risks to patients and staff. Improvements were needed to ensure the provider was aware of the risks relating to fire.
• The provider had staff recruitment procedures which reflected current legislation.
• The provider carried out some ‘highly recommended’ training as per the General Dental Council professional standards. Improvements were needed to ensure all recommended training, in particular, safeguarding of children and vulnerable adults and Basic Life Support were undertaken at the required intervals.
• Infection control procedures at the practice reflected published guidance, though improvements could be made to make provision for handwashing within the decontamination room.

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Implement a system to ensure patient referrals to other dental or health care professionals are monitored appropriately to ensure they are received in a timely manner.
• Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and take into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment.
• Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases and have records available to reflect this.
• Improve the practice's systems for checking and monitoring equipment taking into account relevant guidance and ensure that all equipment is well maintained.