9 July 2019
During an inspection looking at part of the service
We undertook a focused inspection of Pomfret & Farrell Dental on 9 July 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.
The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
We undertook a comprehensive inspection of Pomfret & Farrell Dental on 29 January 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of regulation 12 Safe Care and Treatment and regulation 17 Good Governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Pomfret & Farrell Dental practice on our website www.cqc.org.uk.
As part of this inspection we asked:
• Is it well-led?
If applicable
When one or more of the five questions are not met we require the service to make improvements and send us an action plan (requirement notice only). We then inspect again after a reasonable interval, focusing on the area(s) where improvement was required.
Our findings were:
Are services well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
The provider had made improvements in relation to the regulatory breaches we found at our inspection on 29 January 2019.
Background
Pomfret & Farrell Dental is in Chelmsford, Essex and provides NHS and private treatment for adults and children.
There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available in the practice car park behind the practice. Short and long
stay car parks are available near the practice.
The dental team includes four dentists, eight dental nurses, two dental hygienists, five receptionists and the practice manager. The practice has five treatment rooms.
The practice is owned by a partnership 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. The registered manager at Pomfret & Farrell Dental is one of the partners.
During the inspection we spoke with two dentists 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 to Friday from 9am to 5.30pm.
Our key findings were:
- Rubber dams were used by all clinicians.
- There were processes in place to prevent wrong site surgery.
- Systems were in place to receive patient and medicine safety alerts, ensure there were shared with the team and acted on.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available and regular medical scenarios were undertaken.
- The dentists worked with chair side support. There were risk assessments in place for when the hygienists worked without a nurse.
- A wider range of significant events with detailed records of events and the learning outcomes were in place.
- Systems were in place to ensure all clinicians were up to date with current evidence-based practice.
- Staff recruitment procedures were in place. Staff appraisals had been completed.
- Infection prevention and control audits were undertaken in line with guidance.
- Systems were in place to ensure all staff were fully conversant with consent processes.
- Processes were in place to ensure prescriptions were stored securely and to identify any loss or theft of individual prescriptions.
- There were systems in place to ensure appropriate doses of medicine were now dispensed with the correct labelling and information leaflets provided for patients.
- Action had been taken to address inconsistencies in the standards in dental care records.
- The practice had introduced systems to ensure effective leadership and a culture of continuous audit and improvement.
- Risk assessments were in place to mitigate any risks associated with domiciliary visits.
- Processes were in place to ensure clinicians took into account relevant nationally recognised evidence-based guidance.
- Patient dental records were stored securely.