The Dental Touch

We carried out this announced inspection on 18 September 2019 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 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 that this practice was 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 caring?

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

Are services responsive?

We found that this practice was providing responsive 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

The Dental Touch is in Kingsdown, Bristol and provides private dental treatment to adults and children and NHS treatment to children.

There is level access for people who use wheelchairs and those with pushchairs. There are short stay parking spaces including designated disabled parking spaces allocated near the practice.

The dental team includes two dentists, two dental nurses, two dental hygienists; one of which is also a dental therapist. One of the dental nurses, also acts as the practice manager and receptionist. The practice has three treatment rooms, two of which were currently in use.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at The Dental Touch is the principal dentist.

On the day of inspection, we collected 58 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with two dentists and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 9-6pm

Tuesday and Thursday 8-4pm

Wednesday 8-5pm

Friday 8-2pm

Our key findings were:

• The provider had infection control procedures which reflected published guidance.
• 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.
• The appointment system took account of patients’ needs.
• The provider asked patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.
• Staff knew how to deal with medical emergencies. However, there was one emergency medicine that was not appropriate and some life-saving equipment was not available, in line with recognised guidance.
• The provider had ineffective systems to help them manage risk to patients and staff, such as fire safety and radiation.
• The provider had ineffective staff recruitment procedures.
• Staff worked well as a team. The provider would benefit from providing more opportunities for staff as a team to feedback to continually improve the service.
• The practice appeared clean and well maintained. Although some equipment required servicing.

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

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• Ensure specified information is available regarding each person employed.
• 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:

• Implement protocols and procedures in relation to the Accessible Information Standard to ensure that that the requirements are complied with.
• 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.
• Improve the practice's processes for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken.