The Dental Practice - Duffield

We carried out this announced comprehensive inspection on 20 September 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 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; with the exception of a size 0 oropharyngeal airway and a child size self-inflating bag.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. However, there were no practice specific safeguarding policies for either children or vulnerable adults.
• 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.
• Staff felt involved and supported and worked as a team.
• Complaints were dealt with positively and efficiently.
• The dental clinic had information governance arrangements.

Background

The Dental Practice is in Duffield and provides NHS and private dental care and treatment for adults and children. The NHS contract is for the treatment of children and makes up approximately 10% of the workload.

There is ground floor access within the practice for people who use wheelchairs and those with pushchairs. A removable ramp is available if needed to negotiate the small step at the front door. Car parking spaces, including dedicated parking for disabled people, are available on site at the practice. The practice has made adjustments to support patients with additional needs. These include ground floor treatment rooms, an accessible toilet and a dental chair designed to help patients with restricted mobility to transfer from a wheelchair or walking frame.

The dental team includes 4 dentists, 5 dental nurses, including 2 trainee dental nurses and 2 receptionists. The practice has 2 treatment rooms.

During the inspection we spoke with 2 dentists, 3 dental nurses and 1 receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 9am to 5pm

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

Full details of the regulation the provider was not meeting are at the end of this report.

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

• Improve the practice's processes for the control and of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken for each product.

• Implement an effective system for monitoring and recording the refrigerator temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.

• Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use, including those prescriptions not yet issued.

• Review the practice protocols regarding audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.