Stubbington Avenue Dental Practice

We undertook a follow up desk-based inspection of Stubbington Avenue Dental Practice on 3 July 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 had remote access to a dental professional specialist adviser.

We undertook a comprehensive inspection of Stubbington Avenue Dental Practice on 25 September 2019 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 well led care and was in breach of regulation 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 Stubbington Avenue Dental Practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• 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 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 breach we found at our inspection on 25 September 2019.

Background

Stubbington Avenue Dental Practice is in Portsmouth and provides NHS and private dental treatment to adults and children.

There is level access, with the use of a ramp, for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes two principal dentists, four dental nurses, four dental hygienists, one practice manager and two receptionists. The practice has four treatment rooms.

The practice is owned by a partnership 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 Stubbington Avenue Dental Practice was one of the principal dentists. A registered manager is legally responsible for the delivery of services for which the practice is registered.

The practice is open:

• Monday to Thursday 8.15am – 5.00pm
• Friday 8.00am - 2.30pm

Our key findings were:

• Additional practice policies were now in place for recruitment, prescriptions, referrals, lone working and whistleblowing to help manage risk to patients and staff.
• Improvements had been made by implementing auditing of antibiotic prescribing, and the control and storage of substances hazardous to health.

We are mindful of the impact of COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We carried out this announced inspection on 25 September 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

Stubbington Avenue Dental Practice is in Portsmouth and provides NHS and private dental treatment to adults and children.

There is level access, with the use of a ramp, for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes two dentists, four dental nurses, five dental hygienists, one practice manager and two receptionists. The practice has four treatment rooms.

The practice is owned by a partnership 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 Stubbington Avenue Dental Practice is the principal dentist. A registered manager is legally responsible for the delivery of services for which the practice is registered.

On the day of inspection, we collected 49 CQC comment cards filled in by patients and spoke with three other patients.

During the inspection we spoke with two dentists, two dental nurses, one dental hygienist, one 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 Tuesday 8.30am to 5pm

Wednesday to Friday 8am to 5pm

Our key findings were:

• The practice appeared clean.
• The partners had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• Additional policies were needed for recruitment, prescriptions, referrals, lone working and whistleblowing to help manage risk to patients and staff.
• Improvements could be made by implementing auditing of antibiotic prescribing, and the control and storage of substances hazardous to health.
• The partners had suitable 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.
• The partners had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The partners asked staff and patients for feedback about the services they provided.
• The partners dealt with complaints positively and efficiently.

We identified regulations 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 regulations the provider was not meeting are at the end of this report.

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.