Updated 14 June 2023
We carried out this announced comprehensive inspection on 22 May 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, but some improvements are recommended.
- Staff knew how to deal with medical emergencies.
- The practice had systems to manage risks for patients, staff, equipment and the premises.
- 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.
- Some additional staff training is recommended in specific areas.
Background
St. Leonards Dental Practice is in Exeter and provides mostly NHS dental care and treatment for adults and children. The practice does a small amount of private work.
The practice is not fully accessible, but there is a portable ramp for wheelchair users and a stair lift to the surgeries, which are on the first floor. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.
The dental team includes 6 dentists (one of whom has a special interest in periodontology), 5 dental nurses, 1 trainee dental nurse, 2 trainee dental nurses/receptionists, a head receptionist, a cleaner and a practice manager. The practice has 3 treatment rooms.
During the inspection we spoke with 2 dentists, 3 dental nurses, 2 trainee dental nurses/receptionists 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 Thursday 8.30am – 1.00pm. 2.00pm – 5:30pm.
Friday 8.30am – 1.00pm. 2.00pm – 4.00pm.
The practice had taken steps to improve environmental sustainability. For example, many staff cycled or walked to work and there were steel rings for secured to the practice wall for patients to lock bicycles to.
There were areas where the provider could make improvements. They should:
- Implement an effective system for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
- Improve and develop staff awareness of autism and learning disabilities and ensure all staff receive appropriate training in this.
- Develop systems to ensure an effective process is established for the on-going learning and development needs of individual staff members at appropriate intervals. In particular, fire and legionella risk assessment training.
- 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, the sterilising of 3-in-1 and suction tips, fabric chairs in treatment rooms, local anaesthetics storage, frequency of completion of Time, Steam and Temperature (TST) strips, provision of clean-up kits for bodily fluids and blood and pre-prepared mouthwash in the treatment rooms.