Dental Surgery

We carried out this announced inspection on 8 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 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

The Dental Surgery is in Bolton and provides NHS and private dental care and treatment for adults and children. It is known locally as 272 Dental Care.

There is level access to the practice for people who use wheelchairs and those with pushchairs. On street parking is available near the practice.

The dental team includes five dentists, five dental nurses (one of which manages the practice), a dental hygiene therapist 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 CQC 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 managers at The Dental Surgery are two of the partners.

On the day of inspection, we collected 51 CQC comment cards filled in by patients. These provided a positive view of the dental team and care provided by the practice.

During the inspection we spoke with two dentists, three dental nurses (including the manager) and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Wednesday 9am to 1pm and 2pm to 5:30pm

Thursday 9am to 1pm and 2pm to 7pm

Friday 9am to 1pm and 2pm to 4pm

Our key findings were:

• The practice appeared to be visibly clean, tidy and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The provider systems to help them manage risk to patients and staff should be improved.
• 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. Processes to obtain evidence of professional registration, indemnity and training were not in place.
• 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.
• Radiography equipment was not checked at the appropriate intervals.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• 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:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of Care.

• Ensure specified information is available regarding each person employed.

• Ensure where appropriate, persons employed are registered with the relevant professional body.

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

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

• Implement protocols and procedures in relation to the Accessible Information Standard to ensure that that the requirements are complied with.

• Take action to ensure audits of radiography and infection prevention and control have documented learning points and the resulting improvements can be demonstrated.