Salisbury House Dental Practice

We carried out this announced inspection on 9 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 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 well-led?

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

Background

Salisbury House Dental Practice is in Hammersmith in the London Borough of Hammersmith and Fulham and provides private dental care and treatment for adults and children.

The practice is located close to public transport links and car parking spaces are available near the practice.

The dental team includes one dentist, one specialist, one dental nurse, one hygienist and a receptionist/practice manager. The practice has two treatment rooms.

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 dentist, the dental nurse and the receptionist/practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Wednesday from 9am to 6pm

Thursday from 9am to 7.30pm

Occasional Fridays from 9am to 1pm

Our key findings were:

• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• 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 provided preventive care and supported patients to ensure better oral health.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had information governance arrangements.
• The provider had infection control procedures which reflected published guidance; however improvements were needed to ensure dental instruments were transported safely.
• The practice appeared to be visibly clean and well-maintained. Improvements were needed to ensure facilities and equipment were safe, and that equipment was maintained according to manufacturers’ instructions.
• Staff knew how to deal with emergencies. Emergency equipment and medicines however were not available as described in the Resuscitation Council UK 2021 guidelines.
• Risks to the health and safety of service users and staff had not been suitably identified and mitigated. Improvements were needed to the systems to help the provider manage risks to patients.
• The provider had staff recruitment procedures which reflected current legislation; however, improvements were needed to ensure all appropriate checks were carried out at the time of recruitment.

We identified regulations the provider was not complying with. 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.

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 Faculty of General Dental Practice.
• Review the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.