Abbey Dental Care

We undertook a focused inspection of Abbey Dental Care on 14 January 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 Abbey Dental Care on 18 November 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 safe or well led care and was in breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We carried out a focused inspection on 20 March 2019 to review in detail the actions taken by the provider following the comprehensive inspection in November 2018. We found at this inspection that the provider was safe but still not well led. The provider was still in breach of regulation 17. We undertook a focused follow up inspection of Abbey Dental Care on 16 October 2019. We found the registered provider was still not providing well led care and was in still breach of regulation 17 good governance 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 Abbey dental care on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

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 continued regulatory breach we found at our inspection on 16 October 2019.

Background

Abbey Dental Care is in Glastonbury, Somerset and provides private treatment for adults and children.

There is access via a portable ramp for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes one dentist, one qualified dental nurse, one trainee dental nurse and a dental hygienist. The provider had recruited a consultant to help manage the practice. They attended two to three days a month. The practice has three treatment rooms, two of which were in use.

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 the principal dentist and the management consultant. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Thursday 9am-5pm
• Fridays 9am-4.30pm

Our key findings were:

• The provider had systems and processes in place to effectively assess, monitor and improve the safety and quality of the service provided.
• Effective systems were in place to safely recruit staff.
• Audits were managed effectively and included analysis of results and actions identified.
• Effective systems were in place for the safe use of X-rays.
• The management systems to minimise the risk that can be caused from substances hazardous to health had improved.

We undertook a focused inspection of Abbey Dental Care on 16 October 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 Abbey Dental Care on 18 November 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 safe or well led care and was in breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We carried out a focused inspection on 20 March 2019 to review in detail the actions taken by the provider following the comprehensive inspection in November 2018. We found at this inspection that the provider was safe but still not well led. The provider was still in breach of regulation 17. You can read our reports of these inspections by selecting the 'all reports' link for Abbey dental care on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

The provider had made insufficient improvements to put right the shortfalls and had not responded to the regulatory breach we found at our inspections on 18 November 2018 and 20 March 2019.

Background

Abbey Dental Care is in Glastonbury, Somerset and provides private treatment for adults and children.

There is level access (via a portable ramp) for people who use wheelchairs and those with pushchairs. Car parking spaces, which include blue badge holder spaces, are available near the practice.

The dental team includes one dentist, one qualified dental nurse, one trainee dental nurse and a dental hygienist. The provider had recruited a consultant to help manage the practice. They attend two to three days a week. The practice has three treatment rooms, two of which were in use.

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 the principal dentist, one of the dental nurses and the management consultant. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday 9am-5pm

Fridays 9am-4.30pm

Our key findings were:

• Improvements had been made to health and safety risk assessments which were now more practice specific.
• Improvements had been made to address the actions required following the legionella risk assessment.
• Improvements had been made to the system for managing fire safety.
• The system to manage recruitment still required some improvement.
• The system to manage the control of substances hazardous to health still required improvement.
• The system to manage the risk associated with radiation still required improvement.
• The system to assess audits still required improvement.

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

Full details of the regulation the provider is not meeting are at the end of this report.

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

• Take action to ensure all clinicians 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.

We undertook a focused inspection of Abbey Dental Care on 20 March 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 Abbey Dental Care on 14 November 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 safe and well led care and was in breach of regulations 12 (Safe Care and Treatment) and 17 (Good Governance) 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 14 November 2018 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 We then inspect again after a reasonable interval, focusing on the area 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 14 November 2018.

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

The provider had made insufficient improvements in relation to the regulatory breaches we found at our inspection on 14 November 2018.

Background

Abbey Dental Care is in Glastonbury, Somerset and provides private treatment for adults and children.

The dental team includes the principal dentist, an associate dentist, one trainee dental nurse, one dental hygienist, two receptionists and a practice 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.

During the inspection we spoke with the principal dentist, the trainee dental nurse and the receptionist. We looked at some of the practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Wednesday 8am-6pm

Thursday 9am-6pm

Friday 8am-4pm

Our key findings were:

• The practice was providing care and treatment in a safe way to patients.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had infection control procedures which mostly reflected published guidance. The storage of instruments required improvement.
• Recruitment procedures required improvement.
• The practice had not implemented effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• The practice had inadequate systems to help them manage risk to patients and staff.

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:

• Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• 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.