Hopwood Dental Practice

We carried out this announced inspection on 22 August 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 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 that this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Hopwood Dental Practice is in Lancashire and provides private treatment for adults and private and NHS treatment for children.

The premises are not accessible for people who use wheelchairs. Wheelchair users can be seen at the provider’s sister practice. On street parking is available near the practice.

The dental team includes three dentists, three dental nurses (one of which is the practice manager and one is the receptionist) and a part-time dental hygienist. The practice has three treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Hopwood Dental Practice is the principal dentist.

On the day of inspection, we collected 18 CQC comment cards filled in by patients. Comments about the service suggested patients were treated with care, respect and dignity. They described a professional, friendly and responsive staff team.

During the inspection we spoke with two dentists, two dental nurses, the receptionist 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 Friday 9am to 1pm and 2pm to 4.30pm

Tuesday, Wednesday and Thursday 9am to 1pm and 2pm to 5.30pm

Our key findings were:

• The practice appeared clean, tidy and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Immediate action had to be taken to obtain life-saving equipment. Emergency medicines were available but two items affected by safety alerts had not been identified and removed from the kit.
• The systems to help them identify and manage risk to patients and staff were ineffective.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice did not have appropriate radiographic safety tests and protocols in place.
• The provider had staff recruitment procedures. These did not include Disclosure and Barring Service (DBS) checks or evidence of thorough induction processes.
• The clinical staff provided and documented 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.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had systems to deal with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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 regulations the provider 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 products are stored securely.

• Implement protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.

• 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.