Knowle Dental Practice

We carried out this announced inspection on 8 January 2020 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 Care Quality Commission, (CQC), inspector who was supported by two specialist dental advisers.

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 not providing well-led care in accordance with the relevant regulations.

Background

Knowle Dental Practice is in Knowle, Bristol and provides private dental care and treatment for adults and children.

There is a small step upon entrance in to the practice for people who use wheelchairs and those with pushchairs. There was no patient parking available at the practice. However, the practice was on a bus route and there was the ability to park near the practice. Disabled patients could be dropped off directly outside the practice.

The dental team includes two dentists (who also managed the practice), three dental nurses and one receptionist. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist there. 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 16 CQC comment cards filled in by patients and spoke with four other patients.

During the inspection we spoke with two dentists, three dental nurses and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 8am-8pm

Tuesday 8:30am-5:30pm

Wednesday 8:30am-3pm

Thursday 8:30-8pm

Friday 8:30-1pm

Our key findings were:

• 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 safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• 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. Although we noted they were not always aware of current guidelines
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had a system to deal with complaints efficiently.
• The provider had information governance arrangements.
• The providers leadership needed to improve to ensure the service met current regulations.
• The provider had staff recruitment procedures which mainly reflected current legislation. We noted some improvements could be made.
• The practice appeared to be visibly clean and well-maintained. Although, we found some equipment had not received servicing, when it was required.
• The systems and processes to help them manage risk to patients and staff needed to be improved upon. This included managing actions from risk assessments carried out for legionella and fire safety, ensuring equipment was serviced when it is required and ensuring risk assessments were carried out for substances hazardous to health.

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

Full details of the regulation the provider is not meeting is at the end of this report.

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Take action to ensure the clinicians take into account the guidelines issued by the Department of Health publication ‘Delivering better oral health: an evidence-based toolkit for prevention’ when promoting the maintenance of good oral health.
• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
• Take action to ensure the availability of an interpreter service for patients who do not speak English as their first language.

• Take action to ensure audits of infection prevention and control should ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.