INE Dental Practice

We carried out this announced comprehensive inspection on 25 October 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 five 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:

• Staff provided preventive care and supported patients to ensure better oral health.
• Complaints were dealt with positively and efficiently.
• The dental clinic was not clean and well-maintained.
• The provider’s infection control procedures did not reflect published guidance.
• Appropriate medicines and life-saving equipment were not available.
• The provider did not operate systems to help them manage risk to patients and staff.
• There were ineffective processes in place to prevent abuse of vulnerable adults and children.
• The practice did not have staff recruitment procedures which reflected current legislation.
• Improvements were needed to ensure that clinical staff kept up to date with current guidelines, and information related to patient care was suitably recorded within the dental care records.
• Improvements were needed to protect patients’ privacy within the treatment rooms
• The appointment system took account of patients’ needs. There was scope to improve access to out of hours advice.
• There were ineffective systems to support continuous improvement.
• There were ineffective systems to ensure that staff were up to date with their training.
• There was ineffective leadership and a lack of 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.

Due to the nature of the concerns the provider was issued with a letter stating our intention to take urgent enforcement action. They were given an opportunity to submit (within one working day) an action plan as to how they would mitigate the risks identified by our inspection. The provider submitted an action plan after the deadline, which included the urgent actions they had taken and further improvements they had planned. We judged the improvements proposed were not of a sufficient nature to mitigate the risks we undertook immediate enforcement action. The provider’s CQC registration to undertake regulated activities is suspended for a period of three months.

Following our inspection, the provider has submitted evidence of the action they have taken in response to the concerns we identified on inspection. We will be reviewing this at the follow up inspection.

Background

INE Dental Practice is in New Malden within the London Borough of Kingston-upon-Thames and provides private dental care and treatment for adults and children. The practice advised us that the majority of the patients are members of the local Korean community.

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 the principal dentist, a dental nurse, a receptionist and a practice manager. The practice has 2 treatment rooms.

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

The practice is open:

Monday, Tuesday, Thursday, Friday from 9.30am to 6pm

Saturday from 9.30 to 1.30pm

The practice is closed on Wednesdays.

We identified regulations the provider was not complying with. They must:

• Ensure care and treatment is provided in a safe way to patients
• Ensure patients are protected from abuse and improper treatment
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties
• Ensure specified information is available regarding each person employed.

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:

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