The Park Clinic

We undertook a follow up desk-based review on 25 February 2020. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector.

We undertook a comprehensive inspection of The Park Clinic on 14 August 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for The Park Clinic dental practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area(s) where improvement was required.

Our findings were:

Are services safe?

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

The provider had made improvements in relation to the regulatory breach we found at our desk-based review on 24 February 2020.

Background

The Park Dental Clinic is in Wimbledon in the London Borough of Merton and provides private treatment for adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available for patients outside the practice.

The dental team includes two principal dentists, seven associate dentists, four dental nurses, four dental hygienists, two receptionists (one who is also a qualified dental nurse) and a practice manager. The practice has four treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 The Park Clinic is the one of the principal dentists.

As part of the review we looked at the practice policies and procedures and other records that the provider sent us. We also spoke with the provider and they confirmed the changes they had made.

Our key findings were:

• The practice had recruitment procedures in place that operated effectively to ensure Disclosure and Barring Services (DBS) checks were carried out for all staff who commenced worked in practice.

• Systems were in place for infection control audits to be undertaken at regular intervals. Learning points and resulting improvements were being documented.

We carried out this announced inspection on 14 August 2019 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 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

The Park Clinic is in Wimbledon in the London Borough of Merton and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available for patients outside the practice.

The dental team includes two principal dentists, seven dentists, four dental nurses, four dental hygienists, two receptionists (one who is also a qualified dental nurse) and a practice manager. The practice has four treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 The Park Clinic is one of principal dentist.

On the day of inspection, we collected 32 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists (including one of the principal dentists), two 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: 8.30am-7pm Monday; 8.30am-6pm Tuesday; 8.30am-5pm Wednesday; 8am-6pm Thursday; 8am-4pm Friday and 9am-1pm Saturdays

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The provider had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• 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 provided preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well 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 suitable information governance arrangements.
• The provider had staff recruitment procedures. However, important recruitment checks such as the Disclosure and Barring Services checks were not being undertaken for staff before they commenced work in the practice.

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

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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:

• Take action to ensure infection prevention and control audits 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.
• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.