Mr G Lai & Associates - Harlesden

We carried out this announced focused inspection on 13 April 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 usually ask five key questions, however due to the ongoing pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• 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 to be visibly clean.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• Staff provided preventive care and supported patients to ensure better oral health.
• Staff felt involved and supported and worked as a team.
• The dental clinic had information governance arrangements.
• The practice had infection control procedures which broadly reflected published guidance. However, improvements were needed to ensure the effectiveness of the decontamination process.
• Staff knew how to deal with medical emergencies. However, not all emergency equipment and medicines were available as described in the Resuscitation Council UK 2021 guidelines.
• Risks to staff and patients from undertaking of regulated activities had not been suitably identified and mitigated.
• The clinical staff provided patients’ care and treatment in line with current guidelines, however improvements were needed to ensure that information related to patient care was suitably recorded within the dental care records.
• There was ineffective leadership and a lack of management oversight for the day-to-day management of the service.
• There were ineffective systems to ensure facilities were safe and equipment was serviced and maintained according to manufacturers` guidance.

Background

The provider Mr G Lai & Associates has three practices and this report is about Mr G Lai & Associates- Harlesden.

Mr G Lai & Associates - Harlesden is in Harlesden, in the London Borough of Brent, and provides NHS dental care and treatment for adults and children.

The dental practice is on the ground floor of a high street building with narrow corridors, so it is not accessible to wheelchair users. The service signposts people with mobility needs to nearby practices.

Metered parking spaces are available near the practice and it is also located close to public transport services.

The dental team includes one principal dentist, two dental associates, one qualified dental nurse, one trainee dental nurse and one practice manager. The practice has two treatment rooms.

During the inspection we spoke with one dentist, one qualified dental nurse, one trainee dental nurse, the practice manager and the registered manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 9.30am to 6pm.

Saturday 9.30am 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 that clinicians carry out patient assessments and treatments in compliance with current legislation and take into account relevant nationally recognised evidence-based guidance.