Twickenham Dental Care

We carried out this announced comprehensive inspection on 15 November 2022 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 adviser.

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 was visibly clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The dental clinic had information governance arrangements.
• The practice had staff recruitment procedures which reflected current legislation; however, some staff records were incomplete.
• There were ineffective systems to ensure that staff were up to date with their training.
• There were ineffective systems to support continuous improvement.
• The practice did not have effective systems to help them manage risks, and the leadership and oversight for the day-to-day management of the service needed improvements.

Background

The provider has 2 practices and this report is about Twickenham Dental Care which is in the London Borough of Richmond-upon-Thames and provides private dental care and treatment for adults and children. The practice offers dental implants, orthodontics and sedation services.

There is level access to 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 dental team includes 3 dentists, an orthodontist, a periodontist, an oral surgeon, a dental nurse, a dental hygienist, an orthodontic therapist and 2 receptionists. In addition, a regular locum dental nurse is employed. The practice has 3 treatment rooms.

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

The practice is open:

Monday 8am to 4pm

Tuesday 9am to 7pm

Wednesday 10am to 6pm

Friday 9am to 4.30pm

Saturday 9am to 4pm.

We identified regulation 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:

• Take action to ensure accurate, complete and detailed recruitment records are maintained for all staff and ensure the practice stores records relating to people employed and the management of regulated activities in compliance with legislation and take into account current guidance.
• Implement a system to ensure patient referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner and not lost.
• Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.