Danbury Dental Care Ltd

We carried out an announced comprehensive inspection on 14 March 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Danbury Dental Care is a private dentist located on the main road in the village of Danbury in Essex. The practice is located on the ground floor of a Grade II Listed building which has been adapted to meet the needs of patients. The practice has approximately 3000 patients and has an older than average population. There are two dentists, a hygienist and three dental nurses, one of whom is also the practice manager. The practice is open from 8.30am to 8pm on Mondays and from 8.30am to 5pm Tuesday to Friday. When the practice is closed an answerphone message gives an emergency contact telephone number for one of the dentists who provide out of hours care and advice.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We received feedback from 41 patients via CQC comment cards, this feedback was very positive about the care and treatment received from all staff within the practice.

Our key findings were:

• The practice did not have a system for recording and analysing significant events.
• The practice had identified and managed risks to patients, however not all findings within the fire risk assessment had been acted on.
• The practice did not have a recruitment policy in place; staff had the relevant checks carried out. Staff underwent a thorough induction process.
• The practice had emergency oxygen and emergency medicines available and all staff knew of their location. The practice did not have a defibrillator available and there was no risk assessment in place to address this issue. Staff had received some basic safeguarding training and knew the procedures to follow to raise any concerns. This training was not to the standard expected of dental professionals.
• Infection control procedures were in place, there was a policy available but there was not a lead member of staff and there were no infection control audits carried out.
• Rubber dams were not being used in the treatment of root canal.
• Radiography audits were not being carried out.
• The practice had a complaints policy in place. Complaints were acknowledged and dealt with in a timely manner.
• All staff had evidence of attending basic life support training.
• There were sufficient numbers of suitably qualified staff to meet patients’ needs
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
• Patients received clear and detailed explanations about their proposed treatment, its costs, options and risks. Patients were therefore able to make informed decisions about their choice in treatments.
• We observed that patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs whether they wanted to be seen urgently or for routine appointments.
• Staff meetings were held monthly, these meetings were recorded and staff signed to confirm their attendance.

We identified regulations that were not being met and the provider must:

• Ensure all risks to patient’s safety are well managed by addressing the findings within the fire risk assessment and conducting a risk assessment for the need of a defibrillator.
• Ensure infection control audits are carried out in line with recommended guidance.
• Ensure staff receive the level of safeguarding training that is recommended for dental professionals.
• Ensure radiography audits are carried out to govern the safe, appropriate and effective use of x-rays.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

• Review medicines to be used in the case of emergency to ensure it complies with nationally recognised guidance.

• Review the system for identifying, recording, analysing and sharing significant events.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society

Introduce a practice specific recruitment policy.