Swakeleys Dental Practice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We found this practice was not providing effective care in accordance with the relevant regulations. We will be following up on our concerns to ensure they have been put right by the provider. During our assessment of this key question, we found concerns related to the completeness of patient care records and the practice having an ineffective system to keep dental professionals up to date with current evidence-based practice. These concerns resulted in breaches of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Assessing needs is based on the latest evidence we assessed for the Effective key question.

The provider had systems to ensure that people who used the service received person-centred care and treatment that was appropriate, met their needs and was reflective of their personal preferences. The dentists confirmed, where applicable, they referred patients to a range of specialists in primary and secondary care for treatment the practice did not provide. Improvements were needed to clinicians` understanding of the new staging and grading system for the management of periodontal patients, guidelines for antibiotic prophylaxis for endocarditis patients, management of patients on anticoagulants and the use of rubber dam. The dentists told us they provided preventive care and supported patients to ensure better oral health, however not all clinicians were aware of the relevant guidance. Staff demonstrated some understanding of the need to obtain patients’ consent to care and treatment in line with legislation and guidance. Not all clinicians understood their responsibilities under the Mental Capacity Act 2005, the concept of Gillick competency and parental consent. Staff felt the practice supported them to develop and enabled them to take on lead roles and responsibilities. Staff worked together and with other health and social care professionals to deliver effective care and treatment.

Staff did not have the skills, knowledge and experience to carry out their roles.  The practice did not have systems to keep dental professionals up to date with current evidence-based practice. We looked at 8 patient care records. We noted that a basic periodontal examination (BPE) was not always recorded, even where the patient had not seen by a hygienist first. Periodontal, caries and oral cancer risk assessments, recall based on risk, treatment options and details of consent were not always recorded. We were told that treatment options, relevant risks and benefits and cost would always be discussed, and verbal consent was always taken, however this was not always reflected in the clinical notes we reviewed. The dentist did not always justify, grade and report on the radiographs they took. Staff worked together and with other health and social care professionals to deliver effective care and treatment. The practice had systems for referring patients with suspected cancer under the national two-week wait arrangements.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.