Updated 3 May 2024
We carried out this announced comprehensive inspection on 9 April 2024 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 second CQC inspector and 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 and well-maintained.
- The practice had infection control procedures which reflected published guidance. However, these were not consistently followed.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to manage risks for patients, staff, equipment, and the premises. However, some of the risk assessments completed had outstanding actions such as, the legionella risk assessment.
- 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.
- Clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- 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.
- There was effective leadership and a culture of continuous improvement. However, improvements could be made to audits. In particular, the radiography and infection prevention and control audits did not reflect the practices seen on the day and the antimicrobial prescribing audit did not highlight that antibiotic prescribing was not in line with current guidance.
- Staff felt involved, 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 practice had information governance arrangements.
Background
Crescent Dental Care is in Hale and provides NHS and private dental care and treatment for adults and children.
There is no 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 specialists (including 2 orthodontists, a periodontist, an endodontist, and an implantologist), 4 dentists, 1 dental therapist, 4 dental hygienists, 4 qualified dental nurses, 1 trainee dental nurse, 3 receptionists, 1 administrator, 1 treatment coordinator and a practice manager. The practice has 7 treatment rooms.
During the inspection we spoke with 2 dentists, 1 orthodontist, 1 implantologist/periodontist, 1 dental hygienists, 4 qualified dental nurses, 3 receptionists, 1 treatment coordinator and the practice manager. We looked at practice policies, procedures, and other records to assess how the service is managed.
The practice is open:
Monday and Thursday from 8.30am to 7pm
Tuesday from 8.30am to 6pm
Wednesday from 8.30am to 5pm
Friday from 8.30am to 4.30pm
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, reprocessing of single use items.
- Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, ensuring any outstanding actions from risk assessments are completed.
- Take action to ensure audits of radiography, infection prevention and control, record keeping, and antimicrobial prescribing, are a true reflection of the practice’s procedures and take into account current guidance. The practice should also ensure that, where appropriate, audits have documented learning points, and the resulting improvements can be demonstrated.
- Improve the practice's protocols for medicines management and ensure all medicines are stored and dispensed of safely and securely. In particular, ensuring there is an effective prescription log in place.