The Causeway Dental Practice

We undertook a follow up focused inspection of The Causeway Dental Practice

on 1 October 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who had remoted access to a specialist dental advisers.

We undertook a comprehensive inspection of The Causeway Dental Practice on 6 June 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of regulation 17 Good Governance of the Health and Social Care Act 2008. You can read our report of that inspection by selecting the 'all reports' link for The Causeway Dental Practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements.

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 6 June 2019.

Background

The Causeway Dental Practice is in Teddington in the London Borough of Richmond-upon-Thames in southwest London. The practice provides private dental treatment to patients of all ages.

The practice is located close to public transport services. It is located on the ground floor and has a step-free access. The practice has two treatment rooms.

The dental team includes two principal dentists who own the practice, a dental nurse, a receptionist and a hygienist.

During the inspection we reviewed documents sent to us by the provider.

Our key findings were:

• There were systems in place to monitor the expiry dates of emergency equipment and medicines.
• There were systems to adequately identify and monitor risks in relation to legionella and fire.

The practice had also made the following improvements :

• The practice had a risk assessment in place for when the hygienist worked without chairside assistance.
• Infection control audits were being carried out on a six monthly basis
• A disability access audit had been undertaken that covered a range of disabilities

We carried out this announced inspection on 6 June 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 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

The Causeway Dental Practice is in Teddington in the London Borough of Richmond upon Thames in Southwest London. The practice provides private dental treatment to patients of all ages.

The practice is located close to public transport services. It is located on the ground floor and has a step-free access. The practice has two treatment rooms.

The dental team includes two principal dentists who own the practice, a dental nurse, a receptionist and a hygienist.

On the day of our inspection we received feedback from nine patients.

During the inspection we spoke with the two principal dentists, the dental nurse and the receptionist. We checked practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday-Thursday 8.30 am – 5.30 pm

Friday 8.30 am – 4.00 pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures in place.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available, although some improvements were required.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures, though some improvements were required.
• 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 had effective leadership.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice had arrangements to deal with complaints positively and efficiently.
• Improvements were required in relation to the assessment and monitoring of risks.

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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

• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping. This relates specifically to recording information in relation to patient assessments, use of rubber dam and preventative advice given.

• 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 considering the guidance issued by the General Dental Council.

• Review the practice’s audit protocols to ensure audits of various aspects of the service, such as infection prevention and control are undertaken at regular intervals to help improve the quality of service. Practice should also ensure, that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.

• Review its responsibilities to meet the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.