St George's Dental Practice

We carried out this unannounced focused inspection on 04 May 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 usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic did not appear to be visibly clean and well-maintained.
• The practice had infection control procedures which did not reflect published guidance.
• Not all staff knew how to deal with medical emergencies. Not all the appropriate medicines and life-saving equipment was available.
• The practice did not have sufficient systems to help them manage risk to patients and staff.
• Safeguarding processes were not in place and not all the staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which did not reflect current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• 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 ineffective leadership and improvements were required regarding the clinical audit cycle.
• Staff felt involved and supported and worked as a team.
• Staff and patients were not currently asked for feedback about the services provided, although complaints were dealt with positively and efficiently.
• The dental clinic had information governance arrangements.

Background

The provider is an individual and this report is about St Georges Dental Practice.

St Georges Dental Practice is in Canterbury 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 people with disabilities, are available near the practice. The ground floor treatment room was currently not in use.

The dental team includes four dentists, one registered dental nurse, who is the practice manager, and three trainee dental nurses who share reception duties. The practice has four treatment rooms, three on the first floor and one on the ground floor that is not in use.

During the inspection we spoke with a dentist, two trainee dental nurses, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

9am to 5pm Monday, Tuesday and Friday

9am to 6pm Wednesday and Thursday

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

• Care and treatment must be provided in a safe way for service users.
• Systems or processes must be established and operated effectively to ensure compliance with the requirements of the fundamental standards as set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• Persons employed for the purposes of carrying on a regulated activity must be fit and proper persons.

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:

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.