Updated 10 May 2019
We carried out this announced inspection on 24 April 2019 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 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 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:
Are services safe?
We found that this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found that this practice was providing effective care in accordance with the relevant regulations.
Are services caring?
We found that this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found that this practice was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found that this practice was providing well-led care in accordance with the relevant regulations.
Background
Smile Care Dental Hamworthy is in Poole and provides NHS and private treatment to adults and children.
There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.
The dental team includes one dentist, one dental nurse, one cleaner and one practice manager/receptionist. The practice has two treatment rooms.
The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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. At the time of inspection there was no registered manager in post as required as a condition of registration. The practice manager had commenced the application procedure to take up the of registered manager at Smile Care Dental Hamworthy. A registered manager is legally responsible for the delivery of services for which the practice is registered
On the day of inspection, we collected eight CQC comment cards filled in by patients and spoke with two other patients.
During the inspection we spoke with one dentist, one dental nurse, one receptionist/manager, one operations manager, one clinical manager, one area manager and the company chief executive. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday to Friday 9am to 6pm
Our key findings were:
- The practice appeared clean and well maintained, although a toilet need repair and a tap needed descaling. Improvements could be made to the cleaning file with additional documentation.
- Whilst there was currently no registered manager in post the provider was supporting the practice manager through the application process.
- The provider had infection control procedures which reflected published guidance. However improvements could be made by a reorganisation of the decontamination room workflow and de cluttering.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to help them manage risk to patients and staff.
- The practice should give consideration to risk assessments for the high volume of work the dentist was expected to complete.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had thorough staff recruitment procedures.
- 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 were providing preventive care and supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- Improvements could be made to Control of Substances Hazardous to Health (COSHH) Regulations 2002 file to ensure the safe storage and use of materials used.
- The provider had effective leadership and culture of continuous improvement, however improvements could be made to the auditing processes with independent verification.
- Staff felt involved and supported and worked well as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- The provider had suitable information governance arrangements.
There were areas where the provider could make improvements. They should:
- Review the provider's registration conditions to ensure the regulated activities at Smile Care Dental Hamworthy are managed by an individual who is registered as a manager.
- Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.
- Review the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities, in particular the dentist work loads.
- Review 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’