Updated 16 February 2023
We carried out this announced comprehensive inspection on 12 December 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 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 was visibly clean, although cleaning schedules were not always completed to demonstrate cleaning tasks were undertaken. The doors of 2 drawers in a treatment room were broken. Other areas of the practice appeared to be well-maintained.
- The practice had an infection control policy in line with guidance but this was not always followed. Equipment was not always stored correctly prior to decontamination and there was no log to demonstrate the frequency of change of heavy-duty gloves used during the decontamination process.
- Staff knew how to deal with medical emergencies. Appropriate medicines were available. However, some items of life-saving equipment were out of date, these were ordered for replacement on the day of inspection.
- The practice’s systems to help them manage risk to patients and staff were not robust or effective. Specifically, fire safety, infection control and equipment servicing.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. However, on the day of inspection, not all staff had completed relevant safeguarding training within the required timescales.
- The practice had staff recruitment procedures which reflected current legislation.
- Patient dental care records did not comply with recommended guidance.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- Staff felt involved and supported and worked as a team.
- Patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The dental clinic had information governance arrangements.
Background
165 Long Street Dental Practice is in Atherstone and provides NHS and private dental care and treatment for adults and children.
A portable ramp can be used to provide access to the practice for people who use wheelchairs and those with pushchairs. Car parking is available on local side roads and parking spaces, including dedicated parking for disabled people, are available in a car park a short distance from the practice. The practice has made some adjustments to support patients with additional needs.
The dental team includes 4 dentists, 3 trainee dental nurses and 2 receptionists. The practice has 3 treatment rooms.
During the inspection we spoke with 2 dentists, 2 dental nurses, 1 receptionist, the practice manager and the registered manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday to Friday from 8.30am to 5.30pm
Saturday from 9am to 3pm
The practice had taken steps to improve environmental sustainability. For example, text messages and confirmation calls are made to patients to remind them of their appointments, this helps to reduce the use of paper. Some staff live local to the practice and walk to work to reduce their carbon footprint. Staff are encouraged to recycle, and the practice is trying to reduce the number of pouches used to store instruments, whilst keeping in line with guidance. The practice will be getting an intra oral scanner, this will help to reduce gypsum waste.
There were areas where the provider could make improvements. They should:
- Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
- Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
- Improve the practice's protocols for medicines management and ensure all medicines are stored and dispensed of safely and securely.
- Take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council. Take action to ensure staff have received training to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
- Improve the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term. In particular, ensure better oversight of staff training and audits