Aigburth Smile Centre Limited

We carried out this announced focussed inspection on 24 November 2021 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 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 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 well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Aigburth Smile Centre is located in South Liverpool and provides NHS and private dental care and treatment for adults and children.

There is no permanent level access to the practice for people who use wheelchairs and/or those with pushchairs. Those patients with limited mobility, or carers and parents with children in prams or pushchairs, can contact the practice staff ahead of their appointment, who can provide a portable ramp to aid access to the practice building. Car parking spaces are available near the practice.

The dental team includes two dentists, three dental nurses, one of whom is a trainee, a dental hygiene therapist, a practice manager and one receptionist. The practice has three treatment rooms. The principal dentist was not available for us to speak with on the day of inspection, but we did have telephone contact with him after the inspection.

The practice is owned by a company and 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 Aigburth Smile Centre is the principal dentist.

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

The practice is open: Monday 9am to 6.30pm, Tuesday, Wednesday and Thursday 9am to 5.30pm and on Friday from 9am to 1.30pm.

Our key findings were:

• The practice appeared to be visibly clean and maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• 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 which reflected current legislation.
• 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 a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements.

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 that staff review and familiarise themselves with the management of water supply to dental chairs and the integrity of the closed system used to manage infection control in water lines to dental chairs.
• Take action to implement any recommendations in the practice's Legionella risk assessment, 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 to ensure that all water outlets, including outside taps are included in the risk assessment and taken account of in any flushing regime in place.
• 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, that X-ray sets are fitted with rectangular collimators.
• Take action to ensure audits of radiography and infection prevention and control 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.
• Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.