Royston Dental Suite

We carried out this announced inspection on 14 November 2017 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. We also wanted to check that the provider had taken action to address the shortfalls we found during our previous inspection of 21 October 2015. A CQC inspector, who was supported by a specialist dental adviser, led the inspection.

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 not providing well-led care in accordance with the relevant regulations.

Background

Royston Dental Suite provides mostly private dental treatment to patients of all ages. The practice is located on the first floor, above shops in Royston High Street and is accessed by a staircase. It has one treatment room, a staff kitchen area, reception, waiting room and a decontamination area. The practice is open Monday to Friday 9am to 5.30pm. For private patients, the practice has extended opening hours on Monday and Thursday evenings until 7.30pm. The staff team consist of a principal dentist, a dental nurse and a receptionist. Locum dentists and nurses are regularly used to cover vacant shifts.

The practice is owned by an individual who is the principal dentist, Dr Shikha Mittal. She has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

During the inspection, we spoke with the principal dentist, a dental nurse and the receptionist. We looked at the practice’s policies and procedures, and other records about how the service was managed. We collected eight comment cards filled in by patients prior to our inspection and spoke with another patient on the day.

Our key findings were:

• The practice had suitable safeguarding processes and staff knew their responsibilities for protecting vulnerable adults and children.

• The appointment system met patients’ needs and patients were able to sign up to text reminders.

• The practice was clean, well maintained, and had infection control procedures that mostly reflected published guidance.

• Staff knew how to deal with medical emergencies and there was suitable equipment available for them.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• There was no system in place to ensure that untoward events were analysed and used as a tool to prevent their reoccurrence.

• Systems to ensure the safe recruitment of staff were not robust, as essential pre-employment checks had not been completed.

• The practice had failed to address a number of shortfalls we had identified at our previous inspection in 2015 in relation to dental care records, employment practices, the provision of a hearing loop and incident reporting.

We identified regulations that were not being met and the provider must:

• Ensure the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff.

There were areas where the provider could make improvements and should:

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result

• Review the practice’s responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010.