Leyton Dental Surgery

We carried out this short notice announced focused inspection on 12 December 2023 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 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.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had some systems to manage risks for patients, staff, equipment and the premises. Improvements were needed to ensure the ongoing management of risks associated with fire, Legionella and the use of hazardous substances were effective.
• 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.
• 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

Leyton Dental Surgery is in Leyton, in the London Borough of Waltham Forest and provides NHS and private dental care and treatment for adults and children.

The practice is on the ground floor of a high street building and the entrance and the corridor leading to the treatment rooms are not easily accessible for people who use wheelchairs and those with pushchairs. The practice has processes in place to communicate this to patients prior to their appointments. Car parking spaces are available near the practice.

The dental team includes the principal dentist, 1 associate dentist, 2 trainee dental nurses, 1 dental hygienist who is registered with the General Dental Council (GDC) as a dentist, 1 dental therapist, 1 practice manager and 1 receptionist, who also carries out nursing duties. The practice has 2 treatment rooms.

During the inspection we spoke with the principal dentist, the associate dentist, 1 trainee dental nurse, 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 to Friday from 9.30am to 6pm

There were areas where the provider could make improvements. They should:

• Improve the practice's processes 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.
• 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, ensure that all outlets are descaled and infrequently used outlets are regularly flushed.
• Take action to implement any recommendations in the practice's fire safety risk assessment and ensure ongoing fire safety management is effective.
• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
• 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, ensure that rectangular collimators are used with the intraoral units to reduce patient exposure.