The Dental Practice

We undertook a follow up focused inspection of The Dental Practice on 12 February 2020.

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 was supported by a specialist dental adviser.

At our inspection on 4 November 2019 we found the registered provider was not providing well led care and was in breach of regulation 17 and regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can read our report of that inspection by selecting the 'all reports' link for The Dental Practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it safe?

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

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 breach we found at our inspection on 4 November 2019.

Background

The Dental Practice is in High Wycombe and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including space for blue badge holders, are available outside the practice.

The dental team includes one dentist, one specialist endodontist, one oral surgeon, three dental nurses, three dental hygienists and a practice manager. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist 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.

During the inspection we spoke with one dentist and the practice manager.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday, Tuesday and Thursday 8.00am – 5.00pm

• Wednesday 1.00pm – 8.00pm

Our key findings were:

• The provider had effective staff recruitment procedures.

• The provider had systems to help them manage risk to patients and staff.

• The practice had effective management leadership.

We carried out this announced inspection on 4 November 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 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 not 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 Dental Centre is in High Wycombe and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including space for blue badge holders, are available outside the practice.

The dental team includes one dentist, one specialist endodontist, one oral surgeon, three dental nurses, three dental hygienists and a practice manager. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist 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 collected 90 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with one dentist, one dental nurses and the practice manager.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday, Tuesday and Thursday 8.00am – 5.00pm
• Wednesday 1.00pm – 8.00pm

Our key findings were:

• The practice appeared clean but not well maintained.
• The provider had infection control procedures which reflected published guidance.
• The provider had systems to help them manage risk to patients and staff, but improvements were needed.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures, but improvements were needed.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect.
• All of the appropriate medicines and life-saving equipment were available.
• 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 well as a team.
• The provider asked patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements, but improvements were needed.
• The practice did not have effective management leadership.

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. Specificity management of fire safety, legionella safety, electrical safety, radiography and staff appraisal.

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

Full details of the regulations the provider is not meeting are at the end of this report.

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.

• Take action to ensure the service takes into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010. Specifically, arrangements to support patients who experience hearing loss.