Witard Dental Health Centre

We carried out this announced focused inspection on 31 January 2023 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 practice 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 always ask 5 key questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive?
• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic appeared to be visibly clean.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Patients were asked for feedback about the services provided.
• Clinical waste was managed safely.
• Fire safety systems were effective.
• Appropriate pre-employment references and Disclosure and Barring Service (DBS) checks had not always been obtained for new staff.
• Oversight of staff training was limited, and there was no system in place to ensure all staff completed the required training or received appraisal of their performance.
• Staff reported a lack of support from the provider and senior managers.
• Overall governance systems in the practice needed to strengthen to ensure a safe service was provided.

Background

Witard Dental Practice is in Norwich and provides both NHS funded and private dental care and treatment for adults and children. The premises are accessible via a portable ramp for wheelchair users and car parking spaces are available in a public car park directly outside the premises. The dental team includes 2 part-time dentists, a practice manager and 3 dental nurses. There are 2 treatment rooms.

During the inspection we spoke with a dentist, a dental nurse and the practice manager. One of the provider’s area managers and a compliance manager were also present. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday to Thursday from 9am to 5pm and Friday from 9am to 4pm.

We identified regulations the provider was not complying with. They must:

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

• 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:

• Take action to ensure dentists are aware of, and follow, the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.

• Take action to ensure the clinicians follow the guidance provided by the College of General Dentistry when completing dental care records. In particular, ensuring patients’ diagnoses is recorded, and periodontal classification and radiograph frequency comply with national guidelines.

• Implement a system to ensure patient referrals to other dental or health care professionals are monitored to ensure they are received in a timely manner and not lost.

• Take action to improve the auditing procedure for antimicrobial prescribing so that it is effective in assessing if clinicians are prescribing according to Faculty of General Dental Practice (UK) 2020 guidelines.