The Tarring Dental Centre

We carried out this announced comprehensive inspection on 14 September 2023 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 advisor.

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 appeared clean and well-maintained.
• The practice had infection control procedures which did not always reflect published guidance.
• Staff knew how to deal with medical emergencies. However, not all appropriate medicines and life-saving equipment were available. Neither had staff carried out medical emergency training suitable for treating patients under sedation.
• The practice had systems to manage risks for patients, staff, equipment and the premises but these required prompt review.
• Safeguarding processes were ineffective.
• The practice had staff recruitment procedures although these did not reflect current legislation.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• Leadership at the practice required review to ensure there was a culture of continuous improvement.
• Staff at the practice worked as a team to deliver patient care.
• Staff and patients were asked for feedback about the services provided although this was not always reviewed effectively.
• Complaints processes required improvement.
• The practice had information governance arrangements which required improvement.

Background

The Tarring Dental Centre is in Tarring and provides NHS and private dental care and treatment for adults and children.

The practice does not offer step free access to the practice for people who use wheelchairs and those with pushchairs. Patients are asked at the first point of contact if they have any accessibility requirements. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 3 dentists, 1 dental nurse who is also the practice manager, 1 trainee dental nurse, 2 dental hygienists and 1 receptionist. The practice has 3 treatment rooms.

During the inspection we spoke with 2 dentists, 1 dental nurse/practice manager, 1 trainee dental nurse, 1 dental hygienist, 1 receptionist and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open: Monday to Friday 8.30am to 5pm

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

• Ensure care and treatment is provided in a safe way to patients
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
• Ensure patients are protected from abuse and improper treatment
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties
• Ensure specified information is available regarding each person employed

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
• Improve and develop staff awareness of autism and learning disabilities and ensure all staff receive appropriate training in this.
• Take action to ensure audits of record keeping and antimicrobial prescribing are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.