The Care Quality Commission
  • Dentist
  • Dentist

Hitchin Dental Practice

7 Highbury Road, Hitchin, Hertfordshire, SG4 9RW (01462) 459172

Provided and run by:
Dr. Nick Farhad Faryad

All Inspections

5 October 2020

During an inspection looking at part of the service

We undertook a desk-based review of Hitchin Dental Practice on 5 October 2020. This was carried out to review the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

We had undertaken a comprehensive inspection on 3 March 2020 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe or well-led care in accordance with the relevant regulations 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 Hitchin Dental Practice on our website .

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 areas where improvement was required.

As part of this review we asked:

  • Is it safe
  • Is it well-led

Background

Hitchin Dental is a well-established practice that offers both private and NHS treatment to about 2,500 patients. The dental team consists of a dentist, a dental nurse, a hygienist and a receptionist. There are three treatment rooms. The practice opens on Mondays to Thursdays from 9 am to 5 pm, and on Fridays from 9 am to 3 pm. There is no level access for wheelchair users. Parking is available on streets nearby.

The practice is owned by an individual who is the dentist there. He has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

Our findings were:

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

  • We found this practice was providing well-led care in accordance with the relevant regulations

Key findings

The provider had made sufficient improvements in relation to the regulatory breaches we found at our previous inspection. These must now be embedded in the practice and sustained in the long-term.

3 March 2020

During a routine inspection

We carried out this announced inspection on 3 March 2020 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 this practice was not 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 caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive 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

Hitchin Dental is a well-established practice that offers both private and NHS treatment to about 2,500 patients. The dental team consists of a dentist, a dental nurse, a hygienist and a receptionist. There are three treatment rooms. The practice opens on Mondays to Thursdays from 9 am to 5 pm, and on Fridays from 9 am to 3 pm. There is no level access for wheelchair users. Parking is available on streets nearby.

The practice is owned by an individual who is the dentist there. He has 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 40 CQC comment cards filled in by patients and spoke with another two.

During the inspection we spoke with the dentist, the nurse and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

  • Staff treated patients with care, dignity and respect. We received many positive comments from patients about the caring and empathetic nature of staff and the effectiveness of their treatment.
  • The practice was small and friendly, something which patients appreciated.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff felt involved and supported and worked as a team.
  • Staff did not follow national public guidance when decontaminating dirty instruments.
  • The management of risk in the practice was limited and control measures to reduce potential hazards had not always been implemented.

  • Audit systems within the practice were limited and had not been used effectively to drive improvement.
  • Governance systems were lacking.

We identified regulations the provider was not meeting. They must:

  • Ensure care and treatment is provided in a safe way to patients.

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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

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

  • Implement an effective system for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
  • Take action to ensure the availability of an interpreter service for patients who do not speak English as their first language.

  • 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.

17 June 2014

During an inspection looking at part of the service

We previously inspected this dental practice on 18 November 2013 and then again on 06 March 2014 when we found that there were a number of shortfalls in the way the provider managed cleanliness and infection control processes. These shortfalls related to the instrument decontamination arrangements and the provider's response to infection control monitoring. We judged that this had a minor impact on people using the service and required the provider to make further improvements.

We inspected the location once more on 17 June 2014 and found that significant improvements had been made and that people were protected from the risk of infection.

The decontamination facilities had been renovated and a dental nurse had been given lead responsibility for infection control. The provider had also employed independent consultants to assist them in identifying and implementing processes that improved the practice's cleanliness and hygiene.

There was a more rigorous approach to instrument decontamination so that the relevant Department of Health (DH) guidance was followed. The designated lead nurse for infection control had a thorough understanding of the DH guidance and of their role in monitoring effectiveness in this area.

6 March 2014

During an inspection looking at part of the service

When we previously inspected Hitchin Dental Practice on 18 November 2013 we found that the provider was not compliant with a number of regulations. There was no suitable information available to support staff in their knowledge of potential abuse or of local safeguarding procedures. The practice did not operate hygienically due to the risk of infection arising from some environmental shortfalls. The provider did not have an effective system to act on feedback or complaints from people and there was no effective infection control audit.

We inspected the service again on 06 March 2014 to consider improvements that the provider said they had made.

We found that people were protected from the risk of abuse because the provider had made arrangements to support staff with information and training about abuse and safeguarding procedures.

There were some shortfalls in the infection control arrangements and the instrument decontamination process which meant that people were not properly protected from the risk of infection. The infection control audit was ineffective in identifying shortfalls.

The provider had taken steps to capture and review feedback from people about the service and to take account of comments and complaints.

18 November 2013

During a routine inspection

People were asked for their signed consent prior to care and treatment commencing. We looked at five people's records and saw that they all included treatment plans signed by the person for each appointment attended.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We looked at the records for five people who used the service. We saw that each file included an updated medical history, treatment plans, and X-rays. People we spoke with were positive about the care and treatment they received. One person told us, 'They're nice, we moved away but still travel to come here.'

We found that although the provider and staff working at the service had some awareness relating to safeguarding people from abuse, their knowledge was limited. Staff at the service had not attended training in relation to safeguarding people from abuse.

There were some systems in place to promote infection control. However, there were some areas of the environment that posed a risk to cleanliness and infection control.

The service had developed surveys to gain people's feedback and they had a complaints policy in place. However, information received was not used in an effective way which ensured that they were monitoring and assessing the quality of the service.