Archived: Richardsons Dental Practice

We carried out this announced focussed inspection on 10 May 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 asked the following three questions:

• 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:

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 well-led?

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

Background

Richardson’s Dental Practice is located in Sutton-in-Ashfield town centre in north Nottinghamshire and provides 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. There are town centre car parks available near the practice including spaces for blue badge holders.

The dental team includes two part-time dentists, two dental nurses, and the provider. The practice has two treatment rooms, both of which are on the ground floor. Currently, only one is in use as the second is being used as a personal protective equipment donning and doffing area.

The practice is owned by an individual. 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 one dentist, one dental nurse and the practice owner. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday: 9am to 5pm.

Our key findings were:

• The practice appeared to be visibly clean.
• A Legionella risk assessment had not been completed.
• There was no Landlords gas safety certificate or five-year fixed wire electrical safety certificate.
• The provider had implemented measures to reduce the risks of COVID-19 to staff and patients.
• The provider had effective? infection prevention and control procedures, although infection control audits were not being carried out.
• Staff knew how to deal with medical emergencies.
• The practice did not have all of the emergency equipment identified in national guidance.
• The provider’s systems to help them identify and manage risk to patients and staff could be strengthened and improved.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider’s staff recruitment procedures did not follow the regulations.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• The quality assurance programme including audits could be improved.
• Staff felt involved and supported and worked as a team.
• The provider did not have systems to ensure staff completed their continuing professional development. Particularly in respect of safeguarding and infection prevention and control.

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 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:

• Take action to ensure dentists are aware of the guidelines issued by the British Endodontic Society for the use of dental dam for root canal treatment.

• Take action to ensure clinical staff are aware of the recognition, diagnosis and early management of sepsis.

• Review the practice protocols regarding audits for prescribing of antibiotic medicinestaking into account the guidance provided by the Faculty of General Dental Practice.

• 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.