Northdown Dental Practice

We carried out this focused unannounced inspection on 20 October 2021 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 three questions:

• 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:

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 well-led?

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

Background

South Cliff Dental Group - Margate is in Margate 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 people with disabilities, are available near the practice.

The dental team includes three dentists, three dental nurses, four trainee nurses, a dental hygienist, two receptionists, a practice manager and an area manager. The practice has seven treatment rooms.

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 Northdown Dental Practice is a member of the head office team.

During the inspection we spoke with two dentists, two dental nurses, two trainee nurses, the dental hygienist, the area manager and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday and Tuesday 10am to 7pm
• Wednesday, Thursday and Friday 8am to 5pm
• The provider had information governance arrangements.

Our key findings were:

• The practice appeared to be visibly clean. We saw areas that needed repair.
• The provider had infection control procedures which did not wholly reflect published guidance in relation to the storage of instruments.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The provider had some systems to help them manage risk to patients and staff.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider did not have staff recruitment procedures which reflected current legislation.
• 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.
• The appointment system did not always take account of patients’ needs. Appointments were often cancelled, sometimes at short notice.
• The provider did not have effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.

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.

Full details of the regulation/s the provider was/is not meeting are at the end of this report.

There were areas where the provider could make improvements. They should:

• Improve the practice's processes for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken for all products used.
• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.