Updated 9 October 2018
We carried out this announced inspection on 30 August 2018 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 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
Townley Dental is in East Dulwich in the London Borough of Southwark. The practice provides NHS and private treatment to patients of all ages.
There is level access for people who use wheelchairs, and those with pushchairs.
The dental team includes four dentists, a dental hygienist, four qualified dental nurses and a practice manager, all of whom also undertake receptionist duties.
The practice has four treatment rooms.
Townley Dental is owned by an individual who is one of the principal dentists there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
On the day of inspection, we obtained feedback from 28 patients.
During the inspection we spoke with the principal dentists, two dental nurses and the practice manager. We checked practice policies and procedures and other records about how the service is managed.
The practice is open at the following times:
- Monday to Thursday: 8.30am – 6pm
- Friday: 8.30am – 5pm
- Saturday: By appointment
Our key findings were:
- Patients gave us positive feedback about all aspects of the service.
- The practice appeared clean and well maintained.
- Staff knew how to deal with emergencies.
- The practice had infection control procedures.
- The practice had safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
- 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.
- The practice was providing preventive care and supporting patients to ensure better oral health.
- The appointment system met patients’ needs.
- The practice dealt with complaints positively and efficiently.
- The practice had suitable information governance arrangements.
- The practice had arrangements in place to support people with mobility and problems, and those who had problems with their vision. They had not carried out a disability access audit to assess how they could meet the needs of other people with a disability including those with hearing loss.
- Staff spoke a variety of languages. The practice did not offer interpreter services for patients who might need them.
- The practice had not ensured a recommended piece of equipment and a medicine were available for use in medical emergencies, and had not ensured appropriate storage of a medicine. The practice addressed this shortly after the inspection.
- Some dental instruments and materials had not been stored appropriately, though the practice addressed this shortly after the inspection.
- the practice addressed this shortly after the inspection.
- The practice had not established effective systems to ensure staff completed key training and received regular appraisals. They sent us further evidence of training completed shortly after the inspection.
- The practice had not established thorough staff recruitment procedures, though they made improvements shortly after the inspection.
- There was a lack of assessment, identification, mitigation and monitoring of various risks, and a lack of effective governance which resulted in shortcomings across the effectiveness and leadership aspects of the service.
During and after this inspection, we brought the shortcomings we identified to the practice’s attention. The responsible person demonstrated willingness to address these issues in order to make the necessary improvements.
We identified a regulation the practice was not meeting. They must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
There are areas where the practice could make improvements. They should:
- Review its responsibilities to respond to meet the needs of patients with disability, taking into account the requirements of the Equality Act 2010, and review the availability of interpreter services for patients who do not speak or understand English, taking into account the Accessible Information Standards.
- Review the fire risk assessment and ensure any identified risks are monitored and mitigated, and all actions are completed promptly.
- Review processes to ensure gypsum is disposed of in line with current recommendations.
- Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.