Updated 3 September 2021
We carried out this announced focused inspection on 10 August 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.
As part of this inspection we 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:
Are services safe?
We found this practice was 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 providing well-led care in accordance with the relevant regulations.
Background
Gentle Dental Care (Worcester) Ltd 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 in pay and display car parks near the practice. There is one dedicated parking bay for patients that are blue badge holders in the practice car park.
The dental team includes three dentists, six dental nurses, four receptionists and a practice manager. The practice has four treatment rooms.
The practice is owned by a company and as a condition of registration must have a person registered with the CQC 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 Gentle Dental Care (Worcester) Ltd is the principal dentist.
During the inspection we spoke with two dentists, one dental nurse, the practice manager and a supporting practice manager from the sister practice in Evesham. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday from 9am to 7.30pm.
Tuesday, Wednesday and Thursday from 9am to 5.30pm.
Friday from 9am to 5pm.
Saturday from 9am to 12pm.
Our key findings were:
- The provider had infection control procedures which reflected published guidance. However, we found two stools with small tears in the upholstery which meant they could not be cleaned effectively. Both stools were removed, and replacement stools were ordered during the inspection.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider had systems to help them manage risk to patients and staff.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which reflected current legislation.
- 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 provider had effective leadership and a culture of continuous improvement. We found that antimicrobial prescribing audits had not been completed. These had been scheduled for completion in the next two months.
- The provider dealt with complaints positively and efficiently.
- The provider had information governance arrangements.
- We identified shortfalls with stock control management systems during our inspection. The provider responded swiftly and following our inspection we were sent evidence to demonstrate that these shortfalls had been addressed.
There were areas where the provider could make improvements. They should:
- Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’. In particular ensuring dental stools are impervious and able to be cleaned effectively.
- Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
- Implement an effective system for identifying, disposing and replenishing of out-of-date stock.