Archived: Azure Dental

We carried out this announced inspection on 28 January 2020 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 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:

Are services safe?

We found this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Azure Dental is in Formby, Merseyside and provides 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 are available near the practice in pay and display car parks or on the residential streets nearby.

The dental team includes two dentists, three dental nurses, one of whom is a trainee, two dental hygiene therapists, one treatment co-ordinator and a practice manager. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 20 CQC comment cards filled in by patients. All feedback provided was highly positive.

During the inspection we spoke with two dentists, two dental nurses, the receptionist 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 and Friday from 9am to 5pm; Tuesday and Wednesday from 9am to 7pm; Thursday from 9am to 6pm and on Saturday by appointment, from 9am to 4pm.

Our key findings were:

• The practice was visibly clean and well-maintained.
• The provider had infection control procedures in place. Not all of these were in line with recognised guidance.
• Staff were not confident in dealing with emergencies. Appropriate medicines were available for use in an emergency, but staff did not have the required needles and syringes to deliver adrenaline if required.
• The practice had medical oxygen available for use but did not have access to the amount of oxygen as described in recognised guidance. Some items of medical emergency kit were missing.
• Systems to help manage risk to patients and staff required review, particularly in relation to some radiation equipment, management of risk from Legionella, electrical safety, and validation of the autoclave in respect of vacuum cycle cleaning of instruments.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and 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.
• The provider had a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements.

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.

Full details of the regulation/s the provider was/is not meeting are at the end of this report.

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.