Updated 26 June 2019
We undertook a focused inspection of Abington Dental Practice on 31 May 2019. 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 Abington Dental Practice on 11 October 2018 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 well led care and was in breach of Regulation 15 and Regulation 17 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 Abington Dental Practice on our website www.cqc.org.uk.
As part of this inspection we asked:
• 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 area(s) where improvement was required.
Our findings were:
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 October 2018.
Background
Abington Dental Practice is in Northampton, a town in the East Midlands region. It provides NHS and private treatment to adults and children.
There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available in the practice’s car park.
The dental team includes four dentists, five dental nurses, two administrators and one receptionist. Practice administrative duties are shared between the principal dentist and the lead nurse.
The practice has three treatment rooms; two of which are on the ground floor.
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 Abington Dental Practice is the principal dentist.
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, Wednesday, Friday from 8am to 6pm, Tuesday and Thursday from 9am to 6pm and Saturday from 9am to 1pm.
Our key findings were:
- Arrangements had improved in relation to ensuring equipment such as the steriliser was validated effectively.
- Standards of hygiene were now effective in relation to the general cleaning of the practice.
- Systems and processes had improved in relation to the reporting and investigating of untoward incidents and significant events.
- The provider demonstrated that systems for audit had improved; we were provided with evidence of audits completed.
- Staff had received an appraisal; this included a review of their performance and their training requirements.
- Risks presented by fire, hazardous substances and legionella had been satisfactorily addressed.
- The practice had not recruited any permanent staff since our previous inspection. It was therefore not possible for us to assess improvement in recruitment procedures.
- Servicing and testing had taken place for air conditioning, gas, and electrical wiring and documentation was available to evidence this.
- The provider assured us that patient safety alerts from the Medicines and Healthcare Products Regulatory Authority (MHRA) were received and reviewed by the principal dentist. They had not maintained a log/audit to demonstrate this however.
- The practice had not implemented a safer sharps system as directed by the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
- At our previous inspection, we identified some items of emergency equipment that were missing from the kit. At our follow up visit, we found that these items were still missing. We were sent evidence to show that items were purchased after our latest visit.
- The practice had implemented a system and process for the security of NHS prescription pads and this enabled monitoring of their use.
- The practice no longer provided conscious sedation to patients.
- The practice had reviewed some of its responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010. They had not obtained a hearing loop or magnifying glass however.
There were areas where the provider could make improvements. They should:
- Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
- Review the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
- Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.