Together Dental Southend

We carried out this announced inspection on 17 May 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 providing well-led care in accordance with the relevant regulations.

Background

Southend Dental Care is in Southend and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including spaces for blue badge holders, are available in a multi-storey car park opposite the practice.

The dental team includes seven dentists, one visiting oral surgeon, one lead dental nurse, a dental nurse who had additional qualifications in sedation, four dental nurses and two trainee dental nurses, three dental hygienists, one receptionist and the practice manager. The practice team is supported by the Operations Business Manager. The practice has six 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. At the time of inspection there was no registered manager in post as required as a condition of registration. A registered manager is legally responsible for the delivery of services for which the practice is registered.

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

During the inspection we spoke with three dentists, the dental nurse who had additional qualifications in sedation, one trainee dental nurse, two receptionists, the Operations Business 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 – 8.30am to 6.30pm

Tuesday – 8.30am to 8.00pm

Wednesday – 8.30am to 6.30pm

Thursday - 8.30am to 8.00pm

Friday - 8.30am to 6.30pm

Saturday - 9am to 1.00pm

Our key findings were:

• The practice is part of a large corporate group which had a support centre located in Brentwood, Essex where support teams including human resources, IT, finance, health and safety, learning and development, clinical support and patient support services were based. These teams supported and offered advice and updates to the practice when required
• The practice appeared clean. There were damaged and chipped areas to the work surfaces in the decontamination room.
• There were no quality assurance or audits in place for the CBCT machine as recommended in guidelines. We noted the mechanical and electrical checks of the X-ray equipment were overdue.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• 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 were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review the practice’s arrangements for ensuring good governance and leadership by complying with registration requirements to ensure that there is a registered manager.
• Review the current staffing arrangements to ensure all dental care professionals 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.
• Review the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account HPA-CRCE-010 Guidance on the Safe Use of Dental Cone Beam (Computed Tomography).
• Review the practice’s systems for environmental cleaning taking into account the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.