Brock Street Dental Practice Limited

We carried out this announced inspection on 27 February 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 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 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.

Background

Brock Street Dental Practice (BSDP) is in Lancaster and provides NHS and private dental care and treatment for adults and children.

There is assisted access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice.

The dental team includes seven dentists, seven dental nurses, one dental hygienist, one dental hygiene therapist, one receptionist and a practice manager. The practice has six treatment rooms two of which are situated on the ground floor.

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 BSDP is the principal dentist.

On the day of inspection, we collected 38 CQC comment cards filled in by patients.

During the inspection we spoke with four dentists, four 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 08:30 - 19:00

Tuesday 08:30 - 17:30

Wednesday 08:00 - 16:30

Thursday 08:30 - 18:00

Friday 08:30 - 16:45

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The process for decontamination of dental instruments was in accordance with published guidance, however the system for infection control procedures could be improved. In particular the legionella management system.
• Staff knew how to deal with emergencies. Not all appropriate medicines and life-saving equipment were available.
• The provider had systems to help them manage risks to patients and staff.
• Staff awareness of the risks associated with sepsis was limited.
• Information held in the practice regarding hazardous substances could be improved.
• Staff awareness of actions to be taken in the event of a fire were limited.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures but these did not fully reflect current legislation.
• 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 and personal information.
• Staff awareness of the Mental Capacity Act and the use of Power of Attorney could be improved.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider did not have effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements.

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

Full details of the regulation the provider was 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.

• 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.