Dental Practice

We carried out this announced focused inspection on 26 April 2022 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 adviser.

To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• 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:

• The dental clinic was visibly clean and well-maintained.
• The practice had infection control procedures in place which took account of published guidance.
• Systems to ensure appropriate medical emergency life-saving equipment was available could be improved.
• The practice had systems to help them manage risk to patients and staff.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Action was required to ensure a fixed electrical installation inspection had been completed.
• The practice had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Improvements could be made to ensure dental care records accurately reflect the quality of the X-rays taken.
• Patients were treated with dignity and respect and staff 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.
• There was an effective management and leadership structure; the provider responded proactively and immediately to the areas we identified for further action.
• Systems to ensure a culture of effective continuous improvement could be improved.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• The dental clinic had information governance arrangements.

Background

Dental Practice is in Waltham, Grimsby and provides NHS and a small amount of 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 is available near the practice on local side roads.

The dental team includes one dentist, three dental nurses, (one of whom is a trainee), two receptionists and a practice manager. The practice has two treatment rooms.

During the inspection we spoke with the dentist, one dental nurse and a receptionist. The practice manager was available remotely. We looked at practice policies and procedures and other records about how the service is managed.

Throughout the inspection day, we identified several areas where further clarification was needed. The practice manager ensured this was achieved where possible during the inspection day, immediately afterwards or within 24 hours of our visit.

The practice is open:

Monday to Friday 9:30am – 5:30pm

There were areas where the provider could make improvements.

• Take action to ensure all areas of the premises are fit for the purpose for which they are being used. In particular, ensure a fixed electrical installation inspection has been carried out.
• Take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK).
• Take action to ensure clinicians record in the patients’ dental care records or elsewhere the reason for taking X-rays, a report on the findings and the quality of the image in compliance with Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment.
• Take action to ensure audits of antimicrobials, radiography and infection prevention and control are accurate and 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 and not lost.