Ringway Dental Care

We undertook a follow-up desk-based inspection of Ringway Dental Care on 4 June 2019. 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 carried out by a CQC inspector.

We undertook a comprehensive inspection of Ringway Dental Care on 18 December 2018 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 or 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 Ringway Dental Care on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it safe?

• Is it well-led?

When one or more of the five 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.

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 breach we found at our inspection on 18 December 2018.

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 breach we found at our inspection on 18 December 2018.

Background

Ringway Dental Care is in Heald Green, Stockport, Cheshire and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Some car parking spaces are available immediately outside the practice, with additional street parking near the practice.

The dental team includes a principal dentist, a visiting dental implantologist, two dental nurses and a receptionist. The practice has two treatment rooms.

The practice is owned by a company 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 Ringway Dental Care is the principal dentist.

During the inspection we spoke with the lead dental nurse and administrative staff. We looked at practice policies and procedures and other records about how the service is managed, and reviewed the practice’s action plan, against improvements implemented.

The practice is open: Monday and Tuesday from 8.30am until 5.00pm, Wednesday 11am until 7.00pm, Thursday 8.30am until 6.30pm and on Friday 9.00am until 3.00pm.

At our inspection of 18 December 2018 we found:

• Staff were not following manufacturer instruction when using products to clean dental unit water lines.

• Appropriate medicines and life-saving equipment were available but some of this required separating from medicines and appliances that were out of date or redundant so not suitable for use.

• Training for some staff in safeguarding of vulnerable adults and children required updating and policies required review.
• The practice recruitment policy was not always followed, and we found some staff checks had not been conducted for all staff.
• Systems to help manage risk to patients and staff required review, including for management of legionella, management of radiation equipment and for governance around the decontamination process for dental equipment.
• Other areas of recommended training for some staff required updating.

• The provider had not made the required declaration to the Health and Safety Executive on the use of radiation equipment.

• Medicines that had passed their use by date had not been safely disposed of.

Our findings at this follow-up inspection were:

• All staff and clinicians had access to updated infection control policies and procedures and these now reflected published guidance. Staff were confident on procedures around the safe management of dental unit water lines.

• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available, in date and suitable for use.

• Suitable safeguarding processes were in place and staff knew and understood their responsibilities for safeguarding vulnerable adults and children. Training for all staff and supporting policies had been updated.

• Updated staff recruitment policies clearly outlined processes to be followed in the recruitment of any new staff member. Updated staff records were in place and held all required checks for staff employed at the practice.

• Systems to help manage risk to patients and staff had been reviewed, including risk assessments for management of legionella, the management of radiation equipment and for conducting efficacy testing on dental instruments that had been through the decontamination process.

• The provider had introduced systems to monitor and provide oversight of all staff training and continuing professional development. All staff had access to an on-line training facility and were allocated time within working hours to undertake required training.

• Governance arrangements had been improved. The practice staff we spoke with demonstrated how this supported them in daily working practice.

• Systems to manage medicines safely were in place. Medicines that were out of date had been disposed of safely.

• Prescribing audits were being carried out to ensure the prescribing of medicines was in accordance with the latest recognised guidance.

• The required declaration had been made to the Health and Safety Executive, in respect of the safe maintenance, operation and management of radiation equipment.