Wigston Dental Care

We carried out this announced focused inspection on 9th March 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 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 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 appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which mostly reflected published guidance. The practice did not ensure waste was segregated and disposed of in compliance with the relevant regulations.
• Staff knew how to deal with medical emergencies. Appropriate emergency medicines and most life-saving equipment were available. Missing equipment including masks were ordered immediately after the inspection.
• The provider had systems to help them manage risk to patients and staff. We found shortfalls in appropriately assessing and mitigating risks in relation to medical emergencies, antimicrobial prescribing and hazardous waste management. Immediate action was taken within 48 hours of our inspection to address these shortfalls.
• 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 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 effective leadership and a culture of continuous improvement.Not all audits were undertaken at regular intervals or had documented learning points to demonstrate the resulting improvements.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• Complaints were dealt with positively and efficiently.
• The dental clinic had information governance arrangements.

Background

Wigston Dental is in Wigston, Leicestershire and provides NHS and private dental care and general dental 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 dental team includes four dentists, five dental nurses three of which are trainee dental nurses, three dental therapists and one practice manager. The practice has two treatment rooms.

During the inspection we spoke with two dentists, two 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:

Monday from 9 am to 7 pm

Tuesday from 9 am to 7 pm

Wednesday from 9 am to 6 pm

Thursday from 9 am to 6 pm

Friday from 9 am to 6 pm

Saturday from 9 am to 1 pm

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

• Improve the practice's waste handling protocols to ensure waste is segregated and disposed of in compliance with the relevant regulations and taking into account the guidance issued in the Health Technical Memorandum 07-01. In particular ensure clinical waste is stored in the correct bins.
• Review the necessity of a second oxygen cylinder where appropriate for the practice's circumstances and take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Take action to ensure audits of infection prevention and control are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated, specifically for radiography, infection control and care records.
• Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.