Latchford Dental Surgery

We carried out this announced comprehensive inspection on 19 October 2022 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 practice 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 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:

• The dental clinic was visibly clean and reasonably well-maintained.
• The practice had infection control procedures which reflected published guidance although improvements were identified.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had some systems to help them manage risk to patients and staff although there were shortfalls identified in assessing and mitigating the risks associated with fire and legionella.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. Not all staff had completed appropriate training for their role in safeguarding.
• The provider had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff 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 have effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The dental clinic had information governance arrangements.

Background

The provider has one practice, and this report is about Latchford Dental Surgery.

Latchford Dental Surgery is in Bedford and provides private dental care and treatment for adults and children.

There are two steps leading to the practice although access to the practice for people who use wheelchairs and those with pushchairs is provided using a ramp to the ground floor surgery. Car parking spaces are available near the practice. The practice has made some adjustments to support patients with additional needs.

The dental team includes 6 dentists, including Specialists in Orthodontics, Endodontics, Periodontics and Prosthodontics, 5 dental nurses, 2 dental hygienists, 1 receptionist, an administrative assistant, a secretary who works offsite, and an accounts manager. The practice has 5 treatment rooms one of which is on the ground floor.

During the inspection we spoke with 2 dentists, and 3 dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 8.45am to 5pm

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.

There were areas where the provider could make improvements. They should:

• Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ In particular, storage of sterilised instruments and the provision of separate facilities for handwashing and manual cleaning in the decontamination room.

• Take action to ensure audits of antimicrobial prescribing and record keeping are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.