We carried out this announced comprehensive inspection on 13 February 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.
- Improvements are required to repair damaged walls in the practice.
- Improvements were required to the practice infection control procedures.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. However, not all staff had completed safeguarding training.
- The practice had staff recruitment procedures which reflected current legislation.
- Patient care records did not indicate that care and treatment was in line with current guidelines.
- Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
- Improvements were required to ensure patients were given appropriate preventative care and their oral health was supported.
- 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 and patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The practice had information governance arrangements.
- The practice had systems to manage risks for patients, staff, equipment and the premises. Senior managers had identified that a number of improvements are needed. They had an action plan in place to address these issues.
Background
The provider is part of a corporate group, Smile Dental Care, and this report is about Cattedown Dental Care.
Cattedown Dental Care is in Plymouth and provides NHS and private dental care and treatment for adults and children.
There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.
The dental team includes 4 dentists, 1 dental nurse, 3 trainee dental nurses, a practice coordinator/receptionist and a cleaner. The practice has 4 treatment rooms.
During the inspection we spoke with 2 dentists, 3 trainee dental nurses, the practice coordinator, the provider area manager for the company; and a practice manager from one of the provider’s other practices, who is helping to support the practice in the absence of a practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open: Monday to Friday 9am – 5pm.
We identified regulations the provider is not complying with. They must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
Full details of the regulation the provider is not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- 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’. In particular, in relation to providing suitable brushes for the effective hand cleaning of dental instruments and repair and tears in dental chairs.
- Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular, by using rectangular collimators to reduce the patient exposure to radiation whilst receiving an X-ray.