The Dental Surgery Partnership

We carried out this unannounced focused inspection on 20 October 2021 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 provider 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 asked the following three questions:

• Is it safe?

• Is it effective?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found this practice not providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice not providing effective care in accordance with the relevant regulations.

Are services well-led?

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

Background

The Dental Surgery Partnership (trading as South Cliff Dental Group) is in Brighton and provides NHS and private dental care and treatment for adults and children.

The practice treatment rooms are based on the first floor which is not accessible to people who find stairs a barrier. Car parking spaces are available near the practice.

The dental team includes one dentist, two dental nurses and one receptionist. The practice manager post was vacant. The practice has two treatment rooms.

The practice is owned by a partnership and as a condition of registration must have a person registered with the CQC 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 the practice is the practice manager. We were told this person no longer worked at the practice and was in the process of removing their registration.

During the inspection we spoke with one dentist, one trainee dental nurse and one receptionist.

We also spoke with a trainee dental nurse, a clinical manager and practice manager from nearby practices and the clinical director, all of whom attended the inspection during the day.

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

The practice is open:

• Monday to Saturday 8.30am – 5.30pm

The practice closes for lunch between 1.00pm and 2.00pm daily.

We were told the dentist normally worked Monday to Thursday. The other days the practice did not see patients. We were told this was due to staff shortages.

Our key findings were:

• The practice was not clean and well-maintained.
• The provider’s infection control procedures were not operated effectively
• Appropriate medicines and life-saving equipment were available.
• The provider did not operate effective systems to help them manage risk to patients and staff.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider’s staff recruitment procedures were not operated effectively.
• The clinician provided patients’ care and treatment in line with current guidelines.
• Staff provided preventive care and supported patients to ensure better oral health.
• Appointments were cancelled regularly due to staff shortages.
• The provider did not have effective leadership and a culture of continuous improvement.
• Staff did not feel involved and supported by the provider.
• The provider asked staff and patients for feedback about the services they provided.
• The provider’s information governance arrangements were not operated effectively

The provider accepted all of the clinical and managerial issues that we raised and took immediate action the day of our inspection to begin to address these.

We identified regulations the provider was not complying with. They must:

• Ensure care and treatment is provided in a safe way to patients.
  
  
• Ensure all premises and equipment used by the service provider is fit for use.
  
  
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  
  
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
  
  
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed and specified information is available regarding each person employed.

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