Bristol Dental Anaesthetic Clinic

We carried out this announced focused inspection on 10 February 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 two specialist dental advisers.

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 appeared to be visibly clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Improvements could be made to the sedation process.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk to patients and staff. However improvements could be made to safe management of sharps.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Improvements could be made to the monitoring of outgoing referrals.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The dental clinic had information governance arrangements.

Background

Bristol Dental Anaesthetic Clinic is in Bristol and provides NHS and private dental care and treatment for adults and children.

The access to the practice is via a set of steps. People who use wheelchairs and those with pushchairs are identified at the earliest stage and given alternative arrangements to obtain dental care, where necessary. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice.

The dental team includes six dentists, a lead dental nurse, three dental nurses and a practice manager. The practice has two treatment rooms.

During the inspection we spoke with a dentist, a lead dental nurse and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday 9am to 6pm
• Tuesday 9am to 5pm
• Wednesday 9am to 5pm
• Thursday 9am to 5pm
• Friday 9am to 4pm

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

• Improve the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

• Implement protocols for conscious sedation, taking into account the guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2017.

• 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.