Updated 27 January 2023
We carried out this announced comprehensive inspection on 5 December 2022 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 practice was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a Care Quality Commission, (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 5 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:
- The dental clinic was visibly clean and well-maintained.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with medical emergencies.
- The practice had systems to help them manage risk to patients and staff.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice had staff recruitment procedures which reflected current legislation.
- The clinical staff provided patients’ care and treatment in line with current guidelines. Improvements could be made to the clinical record keeping in relation to the provision of inhalation sedation.
- Patients were treated with dignity and respect and staff 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.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- The dental clinic had information governance arrangements.
Background
Harpers Dental Practice is in Bolton and provides NHS and private dental care and treatment for adults and children. They also provide inhalation sedation to adults and children and domiciliary visits.
There is ramp access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.
The dental team includes 4 dentists, 5 qualified dental nurses, 2 apprentice dental nurses, 1 dental hygienist and therapist, 1 receptionist and a practice manager. The practice has 3 treatment rooms.
During the inspection we spoke with 2 dentists, 1 qualified dental nurse, 1 apprentice dental nurse 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, Wednesday and Thursday from 8:50am to 5:30pm
Tuesday from 8:50am to 7:30pm
Friday from 8:10am to 4:50pm
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. In particular, carrying out the protein residue test on a weekly basis.
- Take action to ensure the clinicians take into account the guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015’. In particular, ensuring the sedation team have received Immediate Life Support training to manage medical emergencies and that the dental care records include detail of the sedation process.