The Whitestar Dental Practice

We carried out this announced inspection on 27 February 2020 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 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:

Are services safe?

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

Are services effective?

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

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

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

Are services well-led?

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

Background

The Whitestar Dental Practice in the London Borough of Harrow and provides NHS and private dental care and treatment for adults and children.

The dental team includes the principal dentist and one receptionist. At the time of our inspection the practice did not have a dental nurse and was using temporary agency nurses and a temporary agency dental hygienist. The practice has two treatment rooms.

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.

On the day of inspection, we collected 33 CQC comment cards filled in by patients.

During the inspection we spoke with the dentist, the receptionist and the agency dental nurse who was present on the day. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between:

9am and 5.30pm on Mondays to Thursdays

9am and 1.00pm on FridaysEarly morning appointments available on Fridays

Our key findings were:

• 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.
• The appointment system took account of patients’ needs.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.
• The provider had safeguarding processes. Improvements were needed to ensure staff undertook training and knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had infection control procedures which reflected published guidance. However these were not adhered to consistently.
• The provider had staff recruitment procedures which reflected current legislation. Improvements were needed so that all the appropriate checks were carried out for agency staff who worked at the practice.
• There were ineffective systems to ensure that suitable numbers of appropriately skilled and trained staff were available to work at the practice.
• There were ineffective arrangements to deal with emergencies. Some life-saving equipment was not available on the day of the inspection and staff did not undertake training or fully understand how to deal with medical emergencies.
• There were ineffective systems to help assess and manage risk to patients and staff.
• The provider had ineffective leadership to support a culture of continuous improvement.
• There were ineffective systems to monitor staff learning needs and to ensure that they understood and followed relevant guidance, policies and procedures.

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.
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are 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:

• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
• Take action to ensure the service takes into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.