Updated 20 November 2019
We carried out this announced inspection on 18 July 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.
Background
Perfect Profiles Clinics is in Moseley Village, Wolverhampton and provides private treatment to adults and children.
There is level access for people who use wheelchairs and those with pushchairs. The practice is in a residential area and although there there is no dedicated parking for the practice there is no shortage of spaces in the surrounding area. There are no dedicated spaces for blue badge holders.
The dental team includes five dentists, five dental nurses, one of whom is also the treatment coordinator, and one of whom is the practice manager. There was a management team based at the sister practice in Luton consisting of five non-clinical staff. The Managing Director and General Manager were on site at Wolverhampton on the day of inspection. The practice has two 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. At the time of inspection we were informed the practice manager had, earlier that week undergone the registered manager interview with the CQC and was subsequently registered on the 29 July 2019.
On the day of inspection, we collected 11 CQC comment cards filled in by patients.
During the inspection we spoke with two dentists and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday to Friday from 9am to 5.30pm.
Our key findings were:
- The practice appeared clean and well maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider had systems to help them manage risk to patients and staff. However, at the time of the inspection the provider did not follow relevant safety regulation when using needles and other sharp dental items, the fire risk assessment required review and not all X-ray equipment had been serviced within appropriate times frames. These issues were rectified following the inspection.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which were not consistently being followed[SK1].
- The clinical staff provided patients’ care and treatment in line with some current guidelines.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- Staff provided preventive care and supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and culture of continuous improvement. At the time of our inspection we did not view safeguarding training for all staff members and IRMER training for one staff member, evidence of completion and course enrolment was sent to us following the inspection.
- 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 dealt with complaints positively and efficiently.
- The provider had suitable information governance arrangements.
There were areas where the provider could make improvements. They should:
- Review the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
- Review the practice's systems for checking and monitoring equipment taking into account relevant guidance and ensure that all equipment is well maintained in particular annual servicing of X-ray equipment.
- Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
- Review the fire safety risk assessment and ensure that any actions required are complete and ongoing fire safety management is effective.
Introduce protocols regarding the prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.