Grandsmiledesigns Limited at Cedar Dental

We carried out this announced comprehensive inspection on 15 September 2022 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 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:

• The dental clinic appeared to be visibly clean and well-maintained.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The registered person had failed to ensure that the premises and all equipment used by the service were properly maintained.
• Improvements were required to the management and governance arrangements.
• The practice had infection control procedures which reflected published guidance. Improvements were required with regards to the completion of infection control audits.
• The systems and processes to help the practice manage risks to patients and staff required improvements.
• The practice had staff recruitment procedures which reflected current legislation. Improvements were required to ensure the practice followed their recruitment procedures.

Background

Grandsmiledesign at Cedar Dental is in the London borough of Sutton and provides private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. The practice has a car park with spaces for patients, including disabled patients parking.

The dental team includes a principal dentist, 3 associate dentists, 3 visiting specialists (1 implant specialist and 2 orthodontists), 2 dental hygienists, 2 dental nurses, 1 trainee dental nurse, 1 treatment co-ordinator (who is also a qualified dental nurse and provides nursing cover), a practice manager and a business manager. The practice has 3 treatment rooms.

During the inspection we spoke with 1 associate dentist, the treatment co-ordinator, a dental nurse, the practice manager and the business manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Saturday 8.30am to 5.30pm

Extended hours till 8.30pm on Thursdays.

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

• Ensure all premises and equipment used by the service provider is fit for use
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
• Ensure specified information is available regarding each person employed

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 audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
• Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.