Berkhamsted Dental Practice

We carried out this announced focused inspection on 23 February 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 appeared to be well-maintained.
• The practice had systems to help them manage risk to patients and staff.
• 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.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• Staff felt involved and 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 dental clinic had information governance arrangements.
• Clinical staff provided patients’ care and treatment in line with current guidelines. However, improvements were needed to ensure that this was reflected suitably in the dental care records.
• The practice’s infection control procedures, particularly the storage of sterilised dental instruments did not always reflect published guidance.
• Staff knew how to deal with medical emergencies. Appropriate emergency medicines and most life-saving equipment were available. Missing or very old equipment including, paediatric masks and airways were ordered immediately after the inspection.

Background

The provider has one practice and this report is about Berkhamsted Dental Practice.

Berkhamsted Dental Practice is in Berkhamsted, Hertfordshire, and provides private and NHS dental care and treatment for adults and children.

The dental practice is on the first floor and accessed by a set of stairs, so it is not accessible to wheelchair users. The provider signposts patients with such needs to practices nearby. There is car parking available nearby in a multi-story car park.

The dental team includes three specialist dentists, three dental nurses, including one trainee dental nurse, three dental hygienists, and two receptionists. Another dentist who is currently completing foundation training, attends the practice on Saturdays to provide hygienist treatment, and there are two additional visiting specialists. The practice has three treatment rooms.

During the inspection we spoke with two dentists, one dental nurse, one dental hygienist, and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Mondays, Tuesdays and Thursdays from 8am to 6pm

Wednesdays from 8.30am to 6pm

Fridays from 8am to 3pm

And occasional Saturdays from 9am to 1pm.

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

Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation 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 and record keeping taking into account the guidance provided by the College of General Dentistry (CG Dent).

Take action to ensure all clinicians are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.