Whitnash Dental Care

We carried out this announced comprehensive inspection on 19 September 2023 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 advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:

• The dental clinic appeared clean and well-maintained, although cleaning logs were not available.
• Some improvements were required to the practice’s infection control procedures to ensure they reflected published guidance.
• Staff had not received annual training on how to deal with medical emergencies. Systems to ensure appropriate medicines and life-saving equipment were available but could be improved.
• The practice had systems to help them manage risk to patients and staff; improvement was needed in the fire, legionella, sharps and general risk assessments.
• Safeguarding processes in place could be improved, staff had not completed safeguarding training to the required level.
• The practice’s staff recruitment procedures did not always reflect current legislation.
• Systems to ensure staff kept up to date with required training could be improved.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, records did not demonstrate that due regard was given to National Institute of Health and Care Excellence (NICE) guidelines.
• Improvement was needed to ensure governance was effective, systems were embedded, and followed published guidance.
• Staff felt involved, supported and worked as a team.
• The practice had recently introduced a system for obtaining patient’s feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.

Background

Whitnash Dental Care is in Leamington Spa, Warwickshire and provides NHS and private dental care and treatment for adults and children.

A portable ramp is used to access the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 1 dentist, 2 dental nurses and 2 receptionists. The practice has 1 treatment room.

During the inspection we spoke with 1 dentist (the provider), 1 dental nurse and 1 receptionist. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open: Monday from 9am to 6pm, Tuesday to Thursday from 8.30am to 6pm and Friday from 8.30am to 1pm. The practice is closed each day for lunch from 1pm to 2pm.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations 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 clinicians record in the patients’ dental care records or elsewhere the reason for taking X-rays, a report on the findings and the quality of the image in compliance with Ionising Radiation (Medical Exposure) Regulations 2017.
• Take action to ensure the clinicians adopt an individual risk-based approach to patient recalls taking into account the National Institute for Health and Care Excellence guidelines. Take into account the guidance provided by the College of General Dentistry when completing dental care records and take into account the guidelines issued by the Department of Health publication ‘Delivering better oral health: an evidence-based toolkit for prevention’ when promoting the maintenance of good oral health.
• Improve and develop the practice's policies and procedures for obtaining patient consent to care and treatment to ensure they are in compliance with legislation, take into account relevant guidance, and staff follow them.