23 January 2024
During a routine inspection
We carried out this unannounced comprehensive inspection on 23 January 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 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, however, systems to support the cleaning processes required review.
- The practice had infection control procedures which did not always reflect published guidance.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available, but these were not always in date or stored appropriately.
- The practice had some systems to manage risks for patients, staff, equipment and the premises. However, some identified risks required urgent review, and others were missing.
- Staff knew their responsibilities for safeguarding vulnerable adults and children, but safeguarding processes were not up to date.
- The practice did not have recruitment procedures and staff recruitment did not reflect current legislation.
- Clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect. However, staff did not always take care to protect patients’ privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- Improvements could be made to the appointment system to ensure that it works efficiently to respond to patients’ needs.
- Leadership at the practice required urgent review.
- The practice did not have systems in place to obtain feedback about the services provided.
- Improvements to the systems in place to manage complaints were underway.
- The practice had information governance arrangements but these required review.
Background
Poole Orthodontics Ltd is in Broadstone, Poole and provides NHS and private orthodontic dental care and treatment for adults and children.
There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.
The dental team includes 2 orthodontists, an orthodontic therapist, 3 dental nurses, a practice manager and a receptionist. The practice has 3 treatment rooms.
During the inspection we spoke with 2 orthodontists, the orthodontic therapist, 2 dental nurses, the receptionist 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, Wednesday and Friday 8:30 – 5:30pm
Tuesday and Thursday 08:30 – 7pm
We identified regulations the provider was not complying with. They must:
- Ensure care and treatment is provided in a safe way to patients
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
- Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties
- Ensure specified information is available regarding each person employed
Full details of the regulations the provider is not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Implement protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.
- Improve the practice's complaint handling procedures and establish an accessible system for identifying, receiving, recording, handling and responding to complaints by service users.