Burgate Dental Practice

We carried out this unannounced comprehensive inspection on 26 April 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 wholly reflect published guidance. improvements were required in some areas.
• Staff knew how to deal with medical emergencies. However, not all staff had certification to show they had completed training. Not all of the appropriate medicines and life-saving equipment were available. Checking of the emergency medicines and equipment requires improvement.
• The practice had systems to manage risks for patients which needed updating, regarding staff, equipment, and the premises.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. We saw that not all staff had completed safeguarding training to the required level.
• The practice had staff recruitment procedures which 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.
• Staff felt involved, 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 practice had information governance arrangements.

Background

Burgate Dental Practice is in Canterbury and provides private dental care and treatment for adults and children.

Step free access to the practice for people who use wheelchairs and those with pushchairs is not available. 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 4 dentists, 2 registered dental nurses, a trainee dental nurse, 2 dental hygiene therapists and a receptionist, The practice has 2 treatment rooms.

During the inspection we spoke with a dentist, 2 registered dental nurses, the dental hygiene therapist, and the trainee dental nurse. We looked at practice policies, procedures, and other records to assess how the service is managed.

The practice is open:

• Monday, Wednesday, Thursday, and Friday 9am to 5pm
• Tuesday 9am to 6.30pm
• Saturday 9am to 1pm

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

• ensure that all equipment used by the service was properly maintained.
• 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

Full details of the regulation/s 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 Faculty of General Dental Practice.
• Implement an effective system for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
• Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’