Camden High Street Practice Limited

We carried out this announced inspection on 10 December 2021 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 usually ask five key questions. However, due to the ongoing pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These are three of the five questions that form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

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

Are services effective?

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

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Camden High Street Dental Practice - a shop front building is located in the London Borough of Camden and provides NHS and private treatment to patients of all ages.

The practice is within easy reach of local bus and train services. Limited paid car parking spaces are available near the practice.

The practice has four treatment rooms. There is a patient waiting area and a separate decontamination room.

The dental team includes the principal dentist who was temporarily away from the business, five associate dentists, two dental hygienists, five dental nurses and two trainee dental nurses. The clinical team are supported by a compliance manager, two part-time practice managers, two receptionists and one administrator.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Camden High Street Practice Limited was the practice manager.

During the inspection we spoke with one associate dentist, one hygienist, one practice manager, three dental nurses, two receptionists and the compliance manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 8:45am to 6pm

Saturday from 9:45am to 3pm.

Outside of these hours, patients are directed to NHS 111 for emergency care and treatment.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• 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.
• Staff felt involved and supported and worked as a team.
• The provider asked patients for feedback about the services they provided.
• Staff provided preventive care and supported patients to ensure better oral health.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children, however, the policy contained inaccurate information.
• The provider had staff recruitment procedures which reflected current legislation, although these were not always followed when recruiting new members of staff.
• The provider had systems to help them manage most risks to service users, however, improvements were needed.
• Improvements were required to governance arrangements.

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:

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
• Take action to ensure the dentists are aware of the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.