Dale Street Dental Practice

We carried out this announced inspection on 13 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 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

Dale Street Dental Practice is in Milnrow, Rochdale and provides private treatment for adults and NHS and private treatment for children.

There is level access for people who use wheelchairs and those with pushchairs. A large free car park including spaces for blue badge holders, is available near the practice.

The dental team includes one dentist, four dental nurses (one of which is the practice manager and one is the clinical director), one dental hygiene therapist and a receptionist. The practice has two treatment rooms. The dental team is supported by a company director.

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 Dale Street Dental Practice is the clinical director.

On the day of inspection, we collected 22 CQC comment cards filled in by patients. Patients were positive about all aspects of the service the practice provided.

During the inspection we spoke with the dentist, two dental nurses, the company director, the practice manager and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 8am to 3.30pm

Tuesday 9am to 5.30pm (the dentist does not work on Tuesdays)

Wednesday 9am to 7pm

Thursday 8am to 5.30pm

Friday 9am to 5.30pm

Our key findings were:

• The practice appeared clean, tidy and well maintained. The premises had been refurbished to improve the facilities and access for disabled people.
• The provider had infection control procedures which reflected published guidance.
• Appropriate medicines and life-saving equipment were available. We were not assured that all staff had received appropriate training to respond to medical emergencies.
• The provider did not have effective systems to help them identify and manage risk.
• Improvements were needed to enhance the level of understanding of Legionella and its management.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. Improvements were needed to ensure staff completed training and were provided with who to contact in the event of safeguarding concerns.
• The provider had thorough staff recruitment procedures. Except for Disclosure and Barring Service (DBS) checks and references or a risk assessment. The practice did not ensure that dental professionals had appropriate professional indemnity in place.
• The clinical staff provided patients’ care and treatment in line with current guidelines. The documentation and processes to audit radiographs and dental care records could be improved.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice did not have systems to ensure that staff completed highly recommended training.
• Staff provided preventive care and supporting 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 regulation the provider is not meeting are at the end of this report.

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

• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’. In particular, the processes for transporting instruments for decontamination.

• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking X-rays, a full report on the findings and the quality of the image in compliance with Ionising Radiation (Medical Exposure) Regulations 2017.