Gentle Dental Care

We carried out this announced focused inspection on 7 July 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:

• Staff provided preventive care and supported patients to ensure better oral health.
• Improvements were needed to ensure that clinical staff kept up to date with current guidelines, and information related to patient care was suitably recorded within the dental care records.
• The practice infection control procedures were not in accordance with published guidance.
• The practice did not have effective arrangements for dealing with medical emergencies. Some of the life-saving medical emergency medicines and equipment were not available and staff were unclear about emergency procedures.
• There were ineffective processes in place to prevent abuse of vulnerable adults and children.
• Risks to staff and patients from undertaking of regulated activities had not been suitably identified and mitigated.
• There were ineffective systems to ensure that staff were up to date with their training.
• There was ineffective governance and leadership and a lack of continuous improvement.
• There were ineffective systems to ensure facilities were safe and equipment was serviced and maintained according to manufacturers` guidance.
• Improvements were needed to ensure that appropriate chairside support was provided by a dental nurse at all times.

Due to the nature of the concerns the provider was issued with a letter stating our intent to take urgent enforcement action. They were given an opportunity to submit (within one working day) an action plan as to how they intended to mitigate the risks identified by our inspection. The provider submitted an action plan, which included the urgent action they had taken and further improvements they had planned. As the improvements were not of a sufficient nature to mitigate the concerns, we undertook immediate enforcement action, and the provider’s CQC registration to undertake regulated activities is suspended for a period of one month.

Background

Gentle Dental Care is in Golders Green, in the London Borough of Barnet 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 a principal dentist and one qualified dental nurse.

During the inspection we spoke with principal dentist and the dental nurse.

The practice is open:

Monday to Thursday 8.30am to 5pm

Fridays 8.30am to 1pm

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 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.

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)
• Improve staff awareness of sepsis.
• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.