Wellgate Dental Practice

We undertook a follow up inspection of Wellgate Dental practice on 24 February 2020. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Wellgate Dental Practice on 24 February 2020 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well led care and was in breach of regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Wellgate Dental Practice on our website www.cqc.org.uk.

As part of this inspection we asked: Remove as appropriate:

• Is it safe?

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 24 February 2020.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 24 February 2020.

Background

Wellgate Dental Practice is in Clitheroe and provides NHS and private dental care and treatment for adults and children.

There is access to the practice via a portable ramp for people who use wheelchairs and those with pushchairs. Off street parking is available near the practice and local transport links are nearby.

The dental team includes two dentists, one dental hygienist, one dental hygiene therapist, three dental nurse/ receptionists. The practice has two treatment rooms with one based on the ground floor.

The practice is owned by a company 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 Wellgate Dental Practice is the principal dentist.

During the inspection we spoke with the principal dentist and two dental nurses.

The practice is open:

Monday 9am - 5.30pm, Tuesday 9am – 6pm, Wednesday 9am- 7.30pm, Thursday 9am – 5pm and Friday 9am – 4pm

Our key findings were:

• Emergency medicines and life-saving equipment were in line with Resuscitation Council UK standards.
• Improvements to fire, electrical and gas safety had been made.

• Effective monitoring of systems regarding Legionella were now in place.
• Improvements had been made to auditing of x-rays.
• Effective management of decommissioned x-ray equipment was in place and local rules now reflected current practice.

• Storage of the patient dental care records was now secure.
• Improvements had been made to the recording of NHS prescription pads.
• Staff meetings and appraisals were now in place.

We carried out this announced inspection on 21 November 2019 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 always ask the following five 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:

Are services safe?

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

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

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

Background

Wellgate Dental Practice is in Clitheroe and provides NHS and private dental care and treatment for adults and children.

There is access to the practice via a portable ramp for people who use wheelchairs and those with pushchairs. Off street parking is available near the practice and local transport links are nearby.

The dental team includes two dentists, one dental hygienists, one dental hygiene therapist, three dental nurse/ receptionists. The practice has two treatment rooms on based on the ground floor.

The practice is owned by a company 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 Wellgate Dental Practice is the principal dentist.

On the day of inspection, we collected 50 CQC comment cards filled in by patients.

During the inspection we spoke with one dentist and three dental nurse/ receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 9am - 5.30pm, Tuesday 9am – 6pm, Wednesday 9am- 7.30pm, Thursday 9am – 5pm and

Friday 9am – 4pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Medicines and life-saving equipment were not available in line with Resuscitation Council UK guidance.
• Improvements could be made to current systems to help them manage risk to patients and staff; in particular legionella, fire safety, sharps, x-ray, electrical and gas safety.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Systems for reviewing audit and responding to action plans could be improved.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The security of patient dental care records could be improved.

We identified a regulation 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.