Family Dental Care

We carried out this unannounced focused inspection on 28 July 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 and patients were asked for feedback about the services provided.
• The practice did not have infection control procedures which reflected published guidance.
• The practice did not have effective arrangements for dealing with medical emergencies. Not all of the recommended medicines and life-saving equipment were available, and staff were unclear about emergency procedures.
• Effective safeguarding processes were not in place and staff were unclear as to their responsibilities for safeguarding vulnerable adults and children.
• The practice did not have staff recruitment procedures which reflected current legislation.
• There were ineffective systems to support continuous improvement.
• Improvements were needed to the Information Governance policy to take account the General Data Protection Regulation (GDPR) 2018 requirements.
• There was ineffective leadership and a lack of oversight for the day-to-day management of the service.
• Staff generally worked as a team. Improvements were needed to ensure that they were supported and involved in the delivery of care and treatment.
• There were ineffective systems to ensure that staff were up to date with their training.
• The practice had some systems to help them assess and manage risk. There was scope to improve these in order to align them with current guidance and legislation.

Background

Family Dental Care is in the London borough of Kingston-upon-Thames and provides NHS and 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, including dedicated parking for disabled people, are available near the practice.

The dental team includes six dentists, one dental nurse, two dental hygienists, three trainee dental nurses, one practice manager and two receptionists. On the day of inspection, there was also a dental graduate present carrying out work experience prior to professional registration. The practice has four treatment rooms.

During the inspection we spoke with the two principal dentists, two trainee dental nurses and the receptionist who is also a qualified dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 9am to 6.30pm

Saturdays 9am to 1pm

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 sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment.
• 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 recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• 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.

The provider accepted the clinical and managerial issues raised and started to take action to address these.

Where evidence is sent that shows the relevant issues have been acted on, we have stated this in our report but we cannot say that the practice is compliant for that key question as this would not be an accurate reflection of what was found on the day of our inspection.