Darwen Dental Care

We carried out this announced comprehensive inspection on 19 October 2022 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 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:

• The dental clinic was visibly clean and maintained.
• The practice had infection control procedures in place, including for the processing of dental instruments; this did not mirror best practice guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available. Not all staff had received training in this area.
• The practice had systems to help them manage risk to patients and staff. Some systems were not reviewed, updated, or did not reflect recognised best practice.
• 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.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• A number of areas related to continuous improvement, audit, management of NHS prescriptions and completion of patient records would benefit from greater focus.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• There was a system in place to ensure complaints were dealt with positively and efficiently.
• The dental clinic had information governance arrangements.

Background

Darwen Dental Care is in Darwen, Lancashire and provides NHS dental care for children and private treatment for adults and children.

There is a small step to access the practice; there is a ground floor treatment room for people who use some types of mobility aid but is not wheelchair accessible due to the limited width of the passageway leading to this room. Car parking spaces, including dedicated parking for disabled people, are available near the practice in free to use car parks. The practice has made some adjustments to support patients with additional needs, for example, by provision of a handrail to aid those with walking difficulties.

The dental team includes the principal dentist and two dental nurses, one of whom was a trainee. The practice has two treatment rooms.

During the inspection we spoke with all people working at the practice. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday 9am to 1pm, 2pm to 5.30pm and Friday from 9am to 1pm.

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 areas where the provider could make improvements. They should:

• Improve 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’ In particular that the processing of dental instruments in the treatment room does not take place when patients are receiving care and treatment.

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.

• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.