Ivory Bespoke Dentistry

We carried out this announced inspection on 24 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 two specialist dental advisers.

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

Ivory Bespoke Dentistry is in Henley in Arden and provides NHS and private dental treatment to adults and children. The services are provided under two separately registered providers at this location. This report only relates to the provision of general dental care provided by Ivory Bespoke Dentistry Ltd. An additional report is available in respect of the general dental care services which are registered under Dr. Matthew Jones.

There is access for people who use wheelchairs and those with pushchairs with the use of a portable ramp. Car parking spaces, including spaces for blue badge holders, are available in the free shopper’s car parks near the practice.

The dental team includes the principal dentist, three dental nurses, one dental hygienist and one 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 Ivory Bespoke Dentistry is the principal dentist.

On the day of inspection, we collected 14 CQC comment cards filled in by patients and spoke with two patients.

During the inspection we spoke with the principal dentist, one dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday from 9am to 5pm

Tuesday from 9am to 6pm

Wednesday from 9am to 4.30pm

Thursday from 9am to 4:30pm

Friday from 9am to 5pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available, with the exception of clear face masks for the self-inflating bag and a self-inflating bag with reservoir. These items were ordered during the inspection.
• The provider had insufficient systems to help them manage risk to patients and staff. We found shortfalls in appropriately assessing and mitigating risks in relation to legionella, fire safety, recruitment, prescriptions, record keeping and audit.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. We were not shown evidence of safeguarding adults training for the safeguarding lead.
• The provider’s recruitment procedures were not robust and essential pre-employment information such as references were not obtained for all staff. We were not assured that 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 did not demonstrate effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• Governance arrangements required strengthening.
• The provider demonstrated they were taking responsive action to the shortfalls we identified following our visit.

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

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation the provider was not meeting are at the end of this report.