Oracare Dental Practice

We undertook a follow up focused inspection of Oracare Dental Practice on 11 October 2019. 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.

We undertook a comprehensive inspection of Oracare Dental Practice on 12 March 2019 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 and was in breach of regulations 12 safe care and treatment and 17 good governance 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 Oracare 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 this practice was providing safe care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breach we found at our inspection on 12 March 2019.

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 12 March 2019.

Background

Oracare Dental Practice is in the London Borough of Harrow and provides NHS and private treatment to adults and children.

There is access for people who use wheelchairs and those with pushchairs.

The dental team includes the principal dentist, two associate dentists, one hygienist, two dental nurses, one receptionist and a practice manager.

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 the principal dentist via telephone, the receptionist 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 9:30am to 3pm

Wednesday, Thursday and Friday 9:30am to 5pm

Saturday 10am to 4pm

Our key findings were:

• Improvements had been made so that the practice premises were maintained and fit for use.
• The practice had infection control procedures which reflected published guidance and there were arrangements for minimising the risks associated with Legionella.
• The practice had systems to help them manage risk. Improvements had been made so that the risks associate with fire were minimised and a fire risk assessment had been completed.
• The practice had made improvements to its management structure.
• The practice had carried out a Disability Access audit.
• The practice had asked patients for feedback about the services they provided and there were now systems in place for ongoing patient feed to take place.

We carried out this announced inspection on 11 March 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

Oracare Dental Practice in the London Borough of Harrow. The practice provides predominantly private treatments and limited NHS treatment to patients of all ages.

The practice is situated close to public transport bus services.

The dental team includes the principal dentist who owns the practice, one associate dentist, three dental nurses, one trainee dental nurse and a receptionist.

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 received feedback from 15 patients including patents we spoke with during the inspection.

During the inspection we spoke with the principal dentist, a dental nurse and the receptionist.

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

The practice is open:

Monday 9.30am to 2pm

Wednesday to Saturday 9.30am to 5pm

Our key findings were:

• Staff treated patients with dignity and respect and took care to protect their privacy.
• The appointment system met patients’ needs.
• The practice appeared clean and well maintained.
• The practice had arrangements to deal with complaints positively and efficiently.
• The practice asked patients for feedback about the services they provided
• The practice safeguarding policies was up to date, there was information to assist staff on how to report concerns to the local safeguarding agencies
• The practice had infection control procedures which reflected published guidance.
• Dental unit waterlines were disinfected as per national guidelines though further improvements were needed as a Legionella risk assessment had not been carried out.
• Staff knew how to deal with emergencies. Improvements were needed so that the recommended emergency medicines and life-saving equipment were available.
• We saw records confirming the servicing, maintenance and regular checks of equipment and appliances. Improvements were required as the electrical five-year fixed wire safety certificate had not been obtained. The provider sent evidence to show this had been booked to take place in the next few days.
• Radiography and Infection control audits were not carried out in accordance with current guidelines.
• There was ineffective leadership and a lack of clinical and managerial oversight for the day-to-day running of the service.
• The practice did not have suitable information governance arrangements.

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.