Updated 14 November 2022
We carried out this announced comprehensive inspection on 18 October 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 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:
- The dental clinic was visibly clean but not all areas were well-maintained.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with medical emergencies. However, not all appropriate medicines and life-saving equipment were available. Missing items were ordered immediately following our inspection.
- The practice did not have all the required systems to help them manage risk to patients and staff. In particular for gas and electrical safety. These were implemented immediately following our inspection.
- 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 did not always provide patients’ care and treatment in line with current guidelines. The dentists did not use rubber dam when carrying out root canal treatment and we did not see evidence they were carrying out and documenting pocket charts for patients with periodontal disease. Clinical staff we spoke with were not familiar with the current classification of periodontal disease.
- 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.
- Leadership was not consistently effective and a culture of continuous improvement was not always evident.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The dental clinic had information governance arrangements.
Background
Mr Jonathan Robinson is in Birmingham and provides NHS and private dental care and treatment for adults and children.
There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with additional needs.
The dental team includes 1 dentist, 2 dental nurses, and 1 receptionist. The practice has 2 treatment rooms.
During the inspection we spoke with 1 dentist, 1 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:
Mondays from 8.30am to 7pm (closed between 12.30pm to 1.30pm for lunch).
Tuesdays from 8.30am to 6pm (closed between 12.30pm to 1.30pm for lunch).
Wednesdays and Thursdays from 8.30pm to 5pm (closed between 12.30pm to 1.30pm for lunch).
Fridays from 7.30am to 1pm.
There were areas where the provider could make improvements. They should:
- Take action to ensure the ongoing availability of medicines and equipment in the practice to manage medical emergencies taking into account the guidelines issued by the British National Formulary and the General Dental Council.
- Take action to ensure dentists are aware of the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.
- Ensure staff are aware of the the new classification of periodontal and peri-implant diseases and ensure they are carrying out and documenting pocket charts.
- Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular, a rectangular collimator should be used.
- Take action to implement any recommendations in the practice's fire safety risk assessment and ensure ongoing fire safety management is effective.