Archived: Haverhill Dental Centre

Updated 7 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection took place on 21 April 2016 and was led by a CQC inspector and a dental specialist advisor.

The focussed inspection of the practice was carried out to address specific concerns, and was arranged in response to information received from NHS England. We informed the NHS England area team that we were inspecting the practice.

During the inspection, we spoke with the principal dentist, an associate dentist, dental nurses, reception staff and patients. We reviewed policies, procedures and other documents.

Updated 7 July 2016

We carried out an announced focussed inspection on 21 April 2016 to ask the practice the following key questions; Are services effective, responsive and well-led?

Our findings were:

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations

Are services responsive?

We found that this practice was not 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

Haverhill Dental Centre is a mostly NHS dental practice which can be found near the centre of Haverhill, Suffolk. The practice offers general dentistry including fillings, dentures, crowns and bridges to adults and children. It is situated on the ground and first floor of a building, and can accommodate wheelchair access to the ground floor treatment rooms using temporary ramps.

The practice has two dentists, two dental nurses (one of whom works part time) and a receptionist. The ground floor of the building accommodated one treatment room, the reception and waiting areas, a dedicated decontamination room and patient toilet. The first floor houses another treatment room and a staff room, as well as further storage space.

The practice was registered with the Care Quality Commission (CQC) in August 2012.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We received positive feedback from two patients about the services provided. This was through speaking with patients in the practice during our visit.

The inspection was carried out to address specific concerns and was therefore focussed in these areas.

Our key findings were:

• Patients we spoke with commented that the staff were friendly and helpful.
• We found one dental treatment room was well maintained and well equipped but found some shortfalls in the other treatment room where some equipment and practice infrastructure was in a poor state of repair.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines
• Practice staff reported that the Automated External Defibrillator for use in the event of a cardiac arrest was not working due to the lack of a battery.
• The service was aware of the needs of the local population and took those these into account in how the practice was run.
• On the day of our visit the appointment diary for each dentist showed that patients could access treatment and urgent and emergency care if required. However we became aware that there had been a significant number of cancelled appointments in the months preceding our visit.
• On the day of our visit there were enough staff to support the dentists during patient treatment. Staff told us that the practice was often short staffed with respect to dental nurses at various times each week. During these times dentists were not appropriately supported when carrying out patient treatment.
• The practice carried out clinical audits in record keeping, dental radiography and infection control, but these did not always generate an action plan, or the issues raised addressed.

We identified regulations that were not being met and the provider must:

• Ensure availability equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

• Ensure that all equipment used as part of patient care and practice infrastructure is maintained to an appropriate standard.

• Ensure that staffing levels enable dentists to be appropriately supported by a dental nurse at all times when patients are receiving dental care and treatment.

• Ensure that systems are in place to assess and respond to risk, quality and safety of provided services.

There were areas where the provider could make improvements and should:

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.