Pro-Dent Dental Surgery

We carried out this unannounced inspection on 20 October 2021 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 three questions:

• 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:

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 well-led?

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

Background

Pro-Dent Dental Surgery is in Southampton and provides NHS 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 dental team includes three dentists, five trainee dental nurses, a dental hygienist, a practice manager and a receptionist. The practice has three treatment rooms.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Pro-Dent Dental Surgery is the practice manager.

During the inspection we spoke with two dentists, two trainee dental nurses, a receptionist, two practice managers, an area manager 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 8am to 6pm
• Tuesday 8am to 6pm
• Wednesday 8am to 6pm
• Thursday 8am to 6pm
• Friday 8am to 6pm
• Saturday 9am to 5.30pm

Our key findings were:

• The provider must ensure that the practice is visibly clean and well-maintained, including a five yearly mains wiring certificate.
• The provider must ensure that infection control procedures are carried out in accordance with published guidance. Records must include water testing and dental unit water line management results.
• Staff knew how to deal with emergencies. The provider must ensure that appropriate life-saving equipment is available according to guidance and stored appropriately.
• The provider must ensure that risk systems to help them manage risk to patients and staff are actioned and recorded, in particular, the fire risk assessment and COVID-19 fallow time.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider must ensure that sharps are used in accordance with guidance.
• The provider must ensure staff recruitment procedures and records are maintained in line with current legislation.
• The provider must ensure that there is sufficient equipment for patient treatment plans, that all equipment is maintained and, supplied with consumables; and that records are available to confirm maintenance has been completed.
• 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.
• The provider must ensure that waste is correctly stored and disposed of according to guidance and regulation.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had not asked staff and patients for feedback about the services they provided
• The provider did not have records of staff training available and had not completed staff appraisals.
• The provider should ensure that anti-microbial audits take place annually.
• 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.
  
  
• Ensure all premises and equipment used by the service provider is fit for use.
  
  
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  
  
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
  
  
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed and specified information is available regarding each person employed.

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 Faculty of General Dental Practice.

The registered manager accepted the clinical and managerial shortfalls that we raised and took immediate action the day of our inspection to begin to address these.

Where evidence is sent that shows the relevant issues have been acted on, we have stated this in our report but we cannot say that the practice is compliant for that key question as this would not be an accurate reflection of what was found on the day of our inspection.