Ina Health Ltd

We carried out this unannounced focused inspection on 21 September 2022 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 practice 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 usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• 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:

• The dental clinic was visibly clean and well-maintained.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff provided preventive care and supported patients to ensure better oral health.
• Staff felt involved and supported and worked as a team.
• The dental clinic had information governance arrangements.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. Improvements were needed to ensure the safeguarding lead completed training at a level appropriate to their role.
• Staff knew how to deal with medical emergencies. Medical emergency drugs and equipment were however not available and checked as per current national guidance.
• The practice did not have infection control procedures which reflected published guidance.
• The provider did not have suitable staff recruitment procedures to comply with current legislation.
• There were ineffective systems to ensure that staff were up to date with their mandatory training.
• Risks to staff and patients from undertaking of regulated activities had not been suitably identified and mitigated.
• There were inadequate arrangements in place for servicing equipment.
• There were ineffective systems to support continuous improvement.

We brought our concerns to the attention of the registered manager and requested urgent action. They voluntarily decided to close the practice until the missing medical emergency medication and equipment were procured.

Background

Ina Health Ltd is in Palmers Green, in the London Borough of Enfield and provides private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with additional needs.

The dental team includes a principal dentist, 3 associate dentists and a practice manager who also undertakes the duties of the dental nurse. The practice has 2 treatment rooms and a separate decontamination room.

During the inspection we spoke with the practice manager and over the phone with the principal dentist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Wednesday, Thursday 8am to 9pm

Tuesday 8am to 8pm

Friday 8am to 6pm

Saturday 8am to 5pm.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them carry out their duties.
• Ensure specified information is available regarding each person employed.

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

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry (CGDent)
• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
• Improve staff awareness of sepsis.
• Implement an effective system 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.