The Grange Dental Centre

We carried out this announced focused inspection on 30 March 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 COVID-19 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 was visibly clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Safeguarding processes were in place 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 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.
• The dental clinic had information governance arrangements; however improvements were needed in relation to the use of closed-circuit television (CCTV).
• Improvements were needed to the systems used to help the provider manage risks to patients and staff.
• There was a culture of continuous improvement, however improvements were needed to some of the auditing protocols to ensure continuing improvement.
• Staff knew how to deal with medical emergencies. Most medicines and life-saving equipment were available as required.
• The provider had staff recruitment procedures which reflected current legislation. However, improvements were needed to ensure important checks were carried out at the time of recruitment.
• On the day of the inspection, we could not be assured that there were protocols in place to ensure treatment carried out under conscious sedation was carried out safely.

We brought our concerns about the practice of conscious sedation to the attention of the compliance manager and regional manager. They voluntarily decided that dental care and treatment under conscious sedation would not be offered until they could be assured that staff members had undertaken all the relevant training and that systems were in place to ensure patient safety.

Background

The Grange Dental Centre is in Newcastle upon Tyne and provides NHS and private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice. The practice is located close to local transport routes. The practice has made reasonable adjustments to support patients with additional needs, for example the availability of a hearing induction loop.

The dental team includes four dentists, one foundation dentist, four dental nurses, two trainee dental nurses, one dental hygienist, one dental therapist and two receptionists, one receptionist/treatment coordinator and one practice manager. The practice has four treatment rooms.

During the inspection we spoke with three dentists, one dental nurse, the practice manager, the compliance manager and the regional manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday from 9am to 5:30pm

Friday from 9am to 4:30pm

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 is not meeting are at the end of this report.

There were areas where the provider could make improvements. They should:

• Improve the audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.