Updated 24 August 2021
We carried out this announced inspection on 4 August 2021 under 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 always ask the following 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 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
Implant and Dental Practices are based in central Liverpool and provides private dental care and treatment for adults and children.
There is lift access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice on a pay and display basis. Other car parks are available nearby.
The dental team includes two dentists, three dental nurses, one of whom is a trainee, one dental hygiene therapist and a practice manager. 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 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 Implant and Dental Practices is the principal dentist.
During the inspection we spoke with the principal dentist, two dental nurses, the dental hygiene therapist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open from 8.30am to 6pm, Monday to Friday. The practice is able to offer later, evening appointments and some appointments on a Saturday, based on patient demand.
Our key findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures which reflected published guidance. We observed that infection control audit had fallen out of the regular six-monthly cycle and brought this to the attention of the provider.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The labels used for patient medicines dispensed by the practice did not have all the required information printed on them, for example the name, address and contact details of the practice. We brought this to the attention of the provider.
- The provider had systems to help them manage risk to patients and staff.
- All risks from radiation had been assessed and managed in line with recognised guidance. We identified that the provider had still not received a copy of the critical acceptance testing for the newly installed cone beam computed tomography X-ray machine. We recommended that the provider progress chase this.
- 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 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 had effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- The provider had information governance arrangements.
There were areas where the provider could make improvements. They should:
- Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account HPA-CRCE-010 Guidance on the Safe Use of Dental Cone Beam (Computed Tomography). In particular, to progress chase a copy of the critical acceptance testing report in respect of the new CBCT equipment, in order to review whether any recommendations have been made which require action.
- Improve the practice's protocols for medicines management and ensure all medicines are stored and dispensed of safely and securely. In particular, dispensed medicines should include the name, address and contact details of the practice on the dispensing label.
- Take action to ensure audits are undertaken at regular intervals to improve the quality of the service. In particular, that full infection prevention and control audits are carried out on a six-monthly basis.