Updated 7 November 2019
We carried out this announced inspection on 2 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 this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found this practice was providing effective care in accordance with the relevant regulations.
Are services caring?
We found this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found this practice was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
Background
Pearly Whites Dental Surgery is in St. Ives, Cornwall and provides NHS treatment to adults and children.
The treatment room is on the first floor, accessed by a stair case. The premises are not suitable for wheelchair users or people with limited mobility. Patients are signposted to alternative local providers with level access. Car parking spaces are available in the town public car parks. As there is no patient washroom at the premises, patients are directed to public conveniences.
The dental team includes one dentist, one dental hygiene therapist, two trainee dental nurses and a receptionist. The practice has one treatment room.
The practice is owned by an individual who is the principal dentist. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
On the day of inspection, we collected 14 CQC comment cards filled in by patients and spoke with one other patient. This gave us a positive view of the practice.
During the inspection we spoke with the provider/dentist, one trainee dental nurse and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open: Monday/Tuesday/Thursday/Friday 7am – 2pm.
Wednesday (dental hygiene therapist only) 7am – 2pm.
Our key findings were:
- The practice appeared clean and well maintained.
- The provider had infection control processes which reflected published guidance, although improvements could be made to update some policies.
- 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, although improvements could be made.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider 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 provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and a culture of continuous improvement.
- 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 has received no complaints in the last 12 months.
- The provider had suitable information governance arrangements.
There were areas where the provider could make improvements. They should:
- Improve 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, regarding the end to end cleaning and sterilisation process for dental instruments, safe use of autoclaves, Legionella risk and water line management.
- Improve the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, regarding latex use in the practice.
- Implement an effective system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.