26 July 2023
During a routine inspection
We carried out this announced comprehensive inspection on 26 July 2023 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 advisor.
To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 questions:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive to people’s needs?
- Is it well-led?
These questions form the framework for the areas we look at during the inspection.
Our findings were:
- The dental clinic appeared clean and well-maintained.
- The practice had infection control procedures which mostly reflected published guidance.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to manage risks for patients, staff, equipment and the premises. Improvements should be made to improve the security and accountability of medication at the practice.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice had staff recruitment procedures which reflected current legislation.
- Clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system worked efficiently to respond to patients’ needs.
- The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved, supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The practice had information governance arrangements.
Background
White Peak Dental Practice is in Ashbourne and provides private dental care and treatment for adults and children.
There is step free access to the practice with a permanent ramp for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements, through the provision of ground floor treatment rooms, a fixed ramp, an accessible toilet and a hearing loop for patients who use hearing aids.
The dental team includes 5 dentists, 5 dental nurses, 3 dental therapists, a practice manager, a treatment co-ordinator and 2 receptionists. The practice has 4 treatment rooms, 2 of which are on the ground floor.
During the inspection we spoke with 2 dentists, 3 dental nurses, the treatment co-ordinator, a receptionist and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open: Monday: from 8am to 5:30pm, Tuesday, Thursday and Friday: from 9am to 5:30pm and Wednesday from 9am to 8pm.
There were areas where the provider could make improvements. They should:
- Improve the security of medicines and prescriptions in the practice and ensure there are systems in place to track and monitor their use.
- Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’. In particular improve procedures for manual cleaning.
- Take action to ensure audits of radiography and infection prevention and control are undertaken at regular intervals in line with national guidance to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular, ensuring the 3-yearly routine test of the X-ray machines is carried out at the required intervals.