Oakley Dental Practice

We undertook a follow up inspection of Oakley Dental Practice on 12 February 2020. 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 led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Oakley Dental Practice on 11 September 2019 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, 17 and 19 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 Oakley Dental Practice 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 (requirement notice only). 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 breaches we found at our inspection on 11 September 2019.

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 breaches we found at our inspection on 11 September 2019.

Background

Oakley Dental Practice is in Oakley and provides private dental treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes two dentists, one dental nurse/administrator, one dental nurse, one trainee dental nurse, one dental hygiene therapist and one cleaner. The practice has three treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

During the inspection we spoke with one dentist, one dental hygiene therapist and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday 8.30am to 6.30pm
• Tuesday to Thursday 8.30am to 5.30pm
• Friday 8.30am to 12.30pm

Our key findings were:

• The provider had infection control procedures which reflected published guidance.
• Appropriate medicines and life-saving equipment were available.
• The provider had systems to help them manage risk to patients and staff.
• Improvements had been made to the management of equipment maintenance to ensure there were no gaps in planned maintenance.
• The X ray folder contained the required information.
• The practice had obtained sharps safety equipment and staff had been trained in their use.
• A legionella risk assessment had been carried out by an external contractor and the recommendations had either been implemented or were planned.
• The external medical waste bins were secured.
• The provider had staff recruitment procedures which reflected current legislation.
• The practice now had a comprehensive Control of Substances Hazardous to Health (COSHH) Regulations 2002 file with assessments of hazardous substances.
• We saw that the practice had carried out audits for infection prevention control and antimicrobial medicines, and there was a planned approach to ongoing auditing.

We carried out this announced inspection on 11 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 a specialist dental adviser.

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 not 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

Oakley Dental Practice is in Oakley and provides private dental treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes two dentists, one dental nurse/administrator, one dental nurse, one trainee dental nurse, one dental hygienist therapist and one cleaner. The practice has three treatment rooms.

The practice is owned by an individual who is the principal dentist. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 23 CQC comment cards filled in by patients and spoke with three other patients.

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

The practice is open:

Monday 8.30am to 6.30pm

Tuesday to Thursday 8.30am to 5.30pm

Friday 8.30am to 12.30pm

Our key findings were:

• The practice appeared clean.
• Staff knew how to deal with emergencies.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• 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.
• 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 had suitable information governance arrangements.
• There was lack of suitable procedures for infection prevention and control, equipment maintenance, waste management and sharps handling.
• There was lack of availability of equipment in the practice to manage medical emergencies. Risks from undertaking of regulated activities had not been suitably identified and mitigated.
• A legionella risk assessment had not been undertaken.
• Recruitment procedures were not in line with legislation and current guidance.
• Infection prevention and control and antimicrobial audits were not being undertaken.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• 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.
• 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 had suitable information governance arrangements.

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 recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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 Faculty of General Dental practice.