The Care Quality Commission
  • Dentist
  • Dentist

Sterlingway Dental Surgery

40 Sterlingway, Edmonton, London, N18 2XZ (020) 8807 7471

Provided and run by:
Mr. John Kanogo

All Inspections

1 March 2024

During an inspection looking at part of the service

We undertook a follow up focused inspection of Sterlingway Dental on 1 March 2024. This inspection was carried out to review the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental advisor.

Previous regulatory history

An announced focused inspection of Sterlingway Dental Surgery was undertaken on 7 June 2022 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well-led care and was in breach of regulations 12,13,17,18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

An unannounced focused inspection was carried out on 23 September 2022 to review the actions taken by the provider in response to our findings of 7 June 2022. At this follow up inspection we found that while some improvements had been made, a number of areas of concern remained outstanding. We found that the provider was still not providing safe and well-led care and remained in breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Another unannounced focused inspection was carried out on 27 January 2023 to review the actions taken by the provider in response to our findings of 23 September 2022. At this review we found that although the provider had implemented actions to address our previous concerns, we identified new concerns. We found that the provider was still not providing well-led care and remained in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook a third follow-up inspection on 31 March 2023 to review the actions taken by the provider in response to our findings of 27 January 2023. At this inspection we found that the practice implemented some improvements to address our previous findings, but we found some outstanding concerns and identified new issues. We found that the provider was still not providing well-led care and was again not providing safe care. We found the provider was in breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook a fourth follow-up inspection on 5 September 2023 to review the actions taken by the provider in response to our findings of 31 March 2023. At this inspection we found that the practice implemented some improvements to address our previous findings, but we found some outstanding concerns. We found that the provider was still not providing safe and well-led care and was in breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can read our report of that inspection by selecting the 'all reports' link for Sterlingway Dental Surgery on our website www.cqc.org.uk.

As part of this inspection we asked:

  • Is it safe?
  • Is it well-led?

Our findings were:

Are services safe?

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

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 5 September 2023.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 5 September 2023.

Background

Sterlingway Dental Surgery is in Edmonton, in the London Borough of Enfield, 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 dental team includes the principal dentist, 1 dental nurse and 1 trainee dental nurse, who also undertakes receptionist duties. The practice has 2 treatment rooms and a separate decontamination room.

During the inspection we spoke with the dentist, the dental nurse and the trainee dental nurse. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday to Friday from 8am to 7pm.

Saturday from 8am to 2pm.

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

  • Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities including storage of emergency medication and staff awareness of managing medical emergency. In addition, ensure that fire risk assessment is reviewed regularly and the emergency lighting is serviced in a timely manner.
  • Take action to ensure the clinician takes into account the guidance provided by the College of General Dentistry when completing dental care records.
  • Take action to ensure the clinician carries out patient assessments in line with current legislation and takes into account relevant nationally recognised evidence-based guidance. In particular, ensure that the clinician is aware of the current evidence-based practice in relation to the management of periodontal patients.
  • Implement improvements to ensure audits of antibiotic medicines takes into account the guidance provided by the College of General Dentistry and the radiography audit includes a representative sample in line with the current guidance. The practice should also ensure that, where appropriate, audits have documented learning points, and the resulting improvements can be demonstrated.

5 September 2023

During an inspection looking at part of the service

We undertook an unannounced focused inspection of Sterlingway Dental Surgery on 5 September 2023. This inspection was carried out to review the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental advisor.

Previous regulatory history

An announced focused inspection of Sterlingway Dental Surgery was undertaken on 7 June 2022 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well-led care and was in breach of regulations 12,13,17,18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

An unannounced focused inspection was carried out on 23 September 2022 to review the actions taken by the provider in response to our findings of 7 June 2022. At this follow up inspection we found that while some improvements had been made, a number of areas of concern remained outstanding. We found that the provider was still not providing safe and well-led care and remained in breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Another unannounced focused inspection was carried out on 27 January 2023 to review the actions taken by the provider in response to our findings of 23 September 2022. At this review we found that although the provider had implemented actions to address our previous concerns, we identified new concerns. We found that the provider was still not providing well-led care and remained in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook a third follow-up inspection on 31 March 2023 to review the actions taken by the provider in response to our findings of 27 January 2023. At this inspection we found that the practice implemented some improvements to address our previous findings, but we found some outstanding concerns and identified new issues. We found that the provider was still not providing safe well-led care and was in breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can read our report of that inspection by selecting the 'all reports' link for Sterlingway Dental Surgery on our website www.cqc.org.uk.

When 1 or more of the 5 questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

As part of this inspection we asked:

  • Is it safe?
  • Is it well-led?

Our findings were:

Are services safe?

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

The provider had made some improvements to put right the shortfalls and had responded to the regulatory breach we found at our inspection on 31 March 2023. However, some of our previous concerns remained outstanding.

Are services well-led?

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

The provider had made insufficient improvements to put right the shortfalls and had not responded to the regulatory breach we found at our inspection on 31 March 2023.

Background

Sterlingway Dental Surgery is in Edmonton, in the London Borough of Enfield, 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 dental team includes the principal dentist, 1 dental nurse and 1 trainee dental nurse, who also undertakes receptionist duties. The practice has 2 treatment rooms and a separate decontamination room.

During the inspection we spoke with the dentist, the trainee dental nurse and a receptionist (who was otherwise not scheduled to work that day). We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday to Friday from 8am to 7pm.

Saturday from 8am to 2pm.

We identified regulations the provider was not meeting. 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.

31 March 2021

During an inspection looking at part of the service

We undertook an unannounced follow up focused inspection of Sterlingway Dental Surgery on 31 March 2023. This inspection was carried out to review the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental advisor.

We had previously undertaken a comprehensive inspection of Sterlingway Dental Surgery on 7 June 2022 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well-led care and was in breach of regulations 12,13,17,18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook a focused follow up inspection on 23 September 2022 and found that the registered provider had remained in breach of regulations 12 and 17 and was not providing safe and well-led care.

A second follow up inspection was undertaken on 27 January 2023, and we found that the registered provider had remained in breach of regulations 17 and was still not providing well-led care.

You can read our reports of those inspections by selecting the 'all reports' link for Sterlingway Dental Surgery dental practice on our website www.cqc.org.uk.

When 1 or more of the 5 questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

As part of this inspection we asked:

  • Is it well-led?

Additional concerns were identified while undertaking the review of the Well-led key question and we also asked:

  • Is it safe?

Our findings were:

Are services safe?

We found this practice was not providing safe 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.

The provider had made some improvements to put right the shortfalls and had responded to the regulatory breach we found at our inspection on 27 January 2023. However, we identified new concerns and some of our previous concerns remain outstanding.

Background

Sterlingway Dental Surgery is in Edmonton, in the London Borough of Enfield, 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 dental team includes the principal dentist, 1 dental nurse and 1 receptionist. The practice has 2 treatment rooms and a separate decontamination room.

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

The practice is open:

Monday to Friday 8am to 7pm.

Saturday 8am to 2pm.

We identified regulations the provider was not meeting. 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:

  • Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular, ensure that intraoral X-ray units are fitted with a rectangular collimator.
  • Take action to ensure the dentist is aware of the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.

27 January 2023

During an inspection looking at part of the service

We undertook a follow up focused inspection of Sterlingway Dental Surgery on 27 January 2023. This inspection was carried out to review the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a second inspector and a specialist dental advisor.

We had previously undertaken a comprehensive inspection of Sterlingway Dental Surgery on 7 June 2023 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well-led care and was in breach of regulations 12,13,17,18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook a focused follow up inspection on 23 September 2022 and found that the registered provider had remained in breach of regulations 12 and 17 and was still not providing safe and well-led care.

You can read our reports of those inspections by selecting the 'all reports' link for Sterlingway Dental Surgery dental practice on our website www.cqc.org.uk.

When 1 or more of the 5 questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

As part of this inspection we asked:

  • Is it safe?
  • Is it well-led?

Our findings were:

Are services safe?

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

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 27 January 2023.

Are services well-led?

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

The provider had made some improvements to put right the shortfalls and had responded to the regulatory breach we found at our inspection on 7 June 2022 and 23 September 2022. However, we identified new concerns.

Background

Sterlingway Dental Surgery is in Edmonton, in the London Borough of Enfield, 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 dental team includes the principal dentist, 1 dental nurse and 1 receptionist. The practice has 2 treatment rooms and a separate decontamination room.

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

We spoke with one carer who had brought their child to follow up a previous enquiry about an urgent referral. We could not speak with any other patients as no other patients were scheduled to be seen on the day.

The practice is open:

Monday to Friday 8am to 7pm.

Saturday 8am to 2pm.

We identified regulations the provider was not meeting. They must:

  • 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:

  • Improve the practice's protocols for medicines management and ensure all medicines are stored in line with the manufacturer`s guidance.

23 September 2022

During an inspection looking at part of the service

We undertook a follow up focused inspection of Sterlingway Dental Surgery on 23 September 2022. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector was supported by a specialist dental adviser.

We undertook a focused inspection of Sterlingway Dental Surgery on 7 June 2022 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well led care and was in breach of regulations 12,13,17,18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Sterlingway Dental Surgery dental practice on our website www.cqc.org.uk.

When one or more of the 5 questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

As part of this inspection we asked:

• Is it safe?

• Is it well-led?

Our findings were:

Are services safe?

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

The provider had made insufficient improvements to put right the shortfalls and had not responded to the regulatory breaches we found at our inspection on 7 June 2022.

Are services well-led?

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

The provider had made insufficient improvements to put right the shortfalls and had not responded to the regulatory breaches we found at our inspection on 7 June 2022.

Background

Sterlingway Dental Surgery is in Edmonton, in the London Borough of Enfield, 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 dental team includes the principal dentist, 1 dental nurse and 2 part-time receptionists. The practice has 2 treatment rooms and a separate decontamination room.

During the inspection we spoke with the dentist, the dental nurse, and 1 receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 8am to 7pm

Saturday 8am to 2pm.

We identified regulations the provider was not meeting. 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:

  • Improve the practice`s recruitment policy to ensure that appropriate checks, including right to work, are completed.

07 June 2022

During an inspection looking at part of the service

We carried out this announced focused inspection on 7 June 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.
  • 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 practice did not have infection control procedures which reflected published guidance.
  • Staff did not know how to deal with medical emergencies. The medical emergency drugs and equipment were not checked regularly as per current national guidance.
  • There were ineffective processes in place to prevent abuse of vulnerable adults and children.
  • The provider did not have suitable staff recruitment procedures to comply with current legislation.
  • There were ineffective systems to ensure that staff were up to date with their training.
  • Risks to staff and patients from undertaking of regulated activities had not been suitably identified and mitigated.
  • There were ineffective systems to support continuous improvement.
  • There were some arrangements in place for the servicing of equipment. However, improvements were needed to ensure that all dental equipment were serviced and validated in line with the manufacturer`s guidance and the premises were safe.
  • Staff generally worked as a team. However, improvements were needed to ensure that they were supported and involved in the delivery of care and treatment.
  • There was ineffective leadership and a lack of oversight for the day-to-day management of the service.

Background

Sterlingway Dental Surgery is in Edmonton, in the London Borough of Enfield, and provides NHS and private dental care and treatment for adults and children.

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, one dental nurse, one trainee dental nurse and two part-time receptionists. The practice has two treatment rooms.

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

The practice is open:

Monday to Friday 8am to 7pm

Saturday 8am 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.
  • 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 regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them carry out their duties.
  • 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:

  • Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry (CGDent)
  • Ensure clinicians take into account relevant nationally recognised evidence-based guidance when undertaking patient assessments.
  • Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
  • Improve staff awareness of sepsis.

31 January 2013

During a routine inspection

The three patient records we looked at showed patient choice regarding treatment options. We were told that options were explained confidentially: covering risks, benefits and fees. Medical histories were updated at each visit. There were arrangements in place to deal with foreseeable emergencies and all staff had had basic life support training. The practice had emergency equipment available including oxygen, airways and emergency drugs.

The dentist was able to demonstrate an understanding of safeguarding children & vulnerable adults and a child protection and vulnerable adults' protection policy was in place. However, the provider may wish to note that not all staff were aware of the policy and only one staff member had attended safeguarding training.

We spoke with the provider about infection control. We were told that the surgery had recently installed seamless flooring for the treatment room. The dental instrument decontamination room had "clean" and "dirty" areas. Personal protective equipment (disposable aprons, masks and gloves) were used in treatment rooms and decontamination room. Staff had undertaken Infection control training in 2011. Refresher training is planned for February 2013.

Patient's personal records including medical records were accurate and fit for purpose. Patients we spoke to were positive about the accuracy of records and their usefulness as a tool to help them make informed decisions about their care.