We carried out this announced inspection on 14 September 2017 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 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
Complete Dental is in Windsor and provides Private treatment to patients of all ages.
The practice is based on the first floor and as such cannot treat patients who find stairs a barrier. New patients are advised of this when they first contact the practice.
The dental team includes the two dentists, two dental nurses, one dental hygenist, a receptionist who is also the practice manager and a business manager.
The practice has two 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.
On the day of inspection we collected 35 CQC comment cards filled in by patients and obtained the views of two other patients. This information gave us a completely positive view of the practice.
During the inspection we spoke with the principal dentist, a dental nurse and a receptionist who was also the practice manager.
The practice is open 8.30am to 5.30pm Monday to Wednesday, 8.30am to 7pm on Thursday, 8.30am to 3pm Friday and one Saturday a month.
Our key findings were:
- The practice appeared clean and well maintained.
- Generally the practice infection control procedures reflected published guidance.
- Staff knew how to deal with emergencies. The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
- Staff appraisals were not carried out.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Most clinical staff completed the continuous professional development required for their registration with the General Dental Council.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- Risk assessments had not been carried out for needle stick injuries and protection from blood borne virus for those clinical staff without Hep B immunity.
- The appointment system met patients’ needs.
- Staff training records were not collated to assess the status of individual staff competency.
- Staff felt involved and supported and worked well as a team.
- Staff recruitment procedures were not effective.
- The practice asked staff and patients for feedback about the services they provided.
- The practice had a procedure in place to deal with complaints.
- Risk assessments had not been carried out for electrical and gas safety.
We identified regulations the provider was not meeting. They must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- Ensure procedures are established to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk.
- Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
- Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed, and ensure specified information is available regarding each person employed.
There were areas where the provider could make improvements. They should:
- Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.
- Review the practice’s system for recording, investigating and reviewing incidents or significant events, with a view to preventing further occurrences and ensuring that improvements are made as a result.
- Review its responsibilities to the needs of disabled people, including those with hearing difficulties and the requirements of the Equality Act 2010.
- Review availability of an interpreter services for patients who do not speak English as a first language.
- Review arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
- Review availability of equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.