Royal House Dental Centre

We carried out this announced inspection on 20 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 wasaccompanied bya trainee specialist dental adviser 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

Royal House Dental Centre is in Henley on Thames and provides NHS treatment for children and private dental care and treatment for adults and children.

There is step free access, via a portable ramp, to the practice for people who use wheelchairs, and those with pushchairs. On street car parking spaces for disabled people, are available near the practice.

The dental team includes three dentists, two dental nurses, three dental hygienists, two administrators and two receptionists.

The practice has four treatment rooms, two of which have step free access.

The practice is owned by a partnership between an individual and a limited company. 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 manager at Royal House Dental Centre is the one of the senior partners.

On the day of inspection, we collected 71 CQC comment cards filled in by patients and spoke with three other patients.

During the inspection we spoke with three dentists, three dental nurses, one dental hygienist, one receptionist and the practice administrator. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday 8.00am to 5.30pm

• Tuesday 8.00am to 5.30pm

• Wednesday 8.00am to 5.30pm

• Thursday 8.00am to 4.30pm

• Friday 8.00am to 2.30pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance. But improvements were needed.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment wereavailable. we found improvements were needed.
• The provider had systems to help them manage risk to patients and staff.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures but improvements were needed.
• 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 effective leadership but improvements were needed to ensure 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 recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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:

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

• Take action to ensure of radiography and infection prevention and control audits 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.

• Implement a system to ensure patient referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner.