Updated 22 August 2019
We undertook a follow up focused inspection of Apple Dental Care on 6 August 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 Apple Dental Care on 11 March 2019 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 safe care and treatment, 17 good governance and 18 staffing 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 Apple Dental Care 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 (requirement notice only). We then inspect again after a reasonable interval, focusing on the areas 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 11 March 2019.
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 6 August 2019.
Background
Apple Dental Care is in the London Borough of Hammersmith. The practice provides predominantly NHS and some private treatments to patients of all ages.
The practice is located on the ground and lower ground floor of purpose adapted premises. The layout of the building did not afford the provision of step free access or accessible toilet facilities.
The practice is situated close to public transport bus services.
The dental team includes the principal dentist who owns the practice, three associate dentists and three dental nurses. The clinical team are supported by a practice manager and a receptionist.
The practice is owned by a partnership between the principal dentist and the practice manager 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 Apple Dental Care was the practice manager.
During the inspection we spoke with the practice manager, one dental nurse and the receptionist.
We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Mondays between 9am and 7pm,
Tuesdays to Friday between 9am and 6pm and
Saturdays between 9.40am and 1.30pm.
Our key findings were:
- The provider had improved the practice infection control procedures so that they reflected published guidance.
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There were effective arrangements for dealing with medical emergencies and appropriate medicines and equipment were available.
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There were effective arrangements for assessing and mitigating risks to patients and staff.
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There were systems to ensure that staff were supported and undertook appropriate training.
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There were 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).
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The practice had protocols to ensure that patient referrals were monitored suitably.