Archived: C F Ng Dental Practice

We carried out this announced inspection on 10 August 2021 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 provider 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 are three of the five questions that form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was not providing well-led care in accordance with the relevant regulations.

Background

C F Ng Dental Practice is in Tottenham, in the London borough of Haringey and provides NHS general dental treatment to adults and children.

The practice is located on the first floor of a four-storey building close to White Hart Lane over ground train station. There is no level access into the building for people who use wheelchairs or those with pushchairs. The practice has one treatment room which has a designated decontamination area.

The team includes the principal dentist and two dental nurses.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

During the inspection we spoke with the principal dentist and both of the dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open to patients:

Monday to Friday from 9.30am to 12.30pm and 2pm to 5pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had suitable safeguarding processes 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 treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• Staff felt involved and supported and worked well as a team. Staff spoke openly about how much they enjoyed working at the practice.
• The provider had infection control procedures which reflected published guidance; there was no system in place for the quality assurance of these procedures.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available; however, they were not regularly checked to ensure that they were in date and in good condition. The defibrillator pads were past their use by date.
• The practice had some systems to help them assess and manage risk. However, these were not always consistent or in line with current guidance and legislation.
• Risk assessments had not been undertaken to minimise the risk that can be caused from substances that are hazardous to health.
• The provider did not have effective governance systems to monitor the day to day running of the practice.
• There was lack of a quality assurance process to encourage learning and continuous improvement, such as an ongoing audit cycle of infection control, radiography and record keeping.

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.

Furthermore, there were areas where the provider could make improvements. They should:

• Implement an effective system for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
• 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.

Full details of the regulations the provider is not meeting are at the end of this report.