Market House Dental Surgery

We carried out this announced comprehensive inspection on 23 May 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.
• The provider’s infection control procedures were not operated effectively.
• The appointment system worked efficiently to respond to patients’ needs.
• The provider did not operate effective systems to help them manage risk to patients and staff.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider’s staff recruitment procedures were not operated effectively.
• Staff provided preventive care and supported patients to ensure better oral health.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff knew how to deal with medical emergencies, but improvement was needed to ensure emergency equipment was appropriate.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• Staff felt involved, 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 practice had information governance arrangements.
• Improvements were needed to ensure the provider could demonstrate effective leadership and a culture of continuous improvement.

Background

Market House Dental Surgery is in Chalfont St Peter and provides private dental care and treatment for adults and children.

There is step free 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 practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 1 dentist, 2 dental nurses, 1 dental hygienist and 1 receptionist. The practice has 1 treatment room but shares the practice building with a second dentist. Both dentists have a cost share agreement for communal areas and services.

During the inspection we spoke with the principal dentist, 2 dental nurses and the receptionist.

We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

• Monday – Thursday 8.00am to 6.00pm
• Friday 8.00am to 1.00pm

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:

• Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
• Take action to ensure the availability of an interpreter service for patients who do not speak English as their first language.