Wroughton Dental Practice

Updated 24 July 2017

We carried out an announced follow-up inspection at Wroughton Dental Practice on the 2 June 2017. This followed an announced comprehensive inspection on the 3 March 2017 carried out as part of our regulatory functions where breaches of legal requirements were found.

After the comprehensive inspection, the practice wrote to us to say what actions they would take to meet the legal requirements in relation to the breaches.

We revisited Wroughton Dental Practice and checked whether they had followed their action plan.

We reviewed the practice against three of the five questions we ask about services: is the service safe, effective and well-led? This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Wroughton Dental Practice on our website at www.cqc.org.uk.

Background

This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The follow up inspection was led by a CQC inspector who was supported by a specialist dental adviser.

During our inspection visit, we checked that points described in the provider’s action plan had been implemented by looking at a range of documents such as risk assessments, staff files, policies, staff training and availability of equipment.

Our findings were:

• The principal dentist was the safeguarding lead professional and processes were in place for safeguarding adults and children.
• The practice had updated their policies and procedures using a commercially available dental clinical governance system which had been recently introduced by the practice owner.
• The practice had systems to help them manage risk, although some signage needed to be reviewed.
• The practice had staff recruitment procedures and all staff were meeting the requirements of their professional registration.
• There was effective leadership at the practice and systems were in place to share information and learning amongst the team.
• The practice had systems in place to seek feedback from patients.
• The dentist provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• Premises appeared maintained and visibly clean and cleaning equipment seen was in line with current guidelines, although not suitably stored.
• Staff knew how to deal with medical emergencies. Appropriate medicines and most of the life-saving equipment were available. Improvements were still required as there was no Automated External Defibrillator (AED) on the premises, no child face mask for attaching to the self-inflating bag and no recorded log of checks on the emergency drugs and equipment. Although there was a documented operational policy relating to the management of such emergencies the location of the local community AED and who would be responsible for collecting it, was not detailed. There was no documented risk assessment available.
• The practice had infection control procedures which mainly reflected published guidance. There were systems in place to ensure that all equipment used to sterilise instruments was being validated as per national guidelines; and maintained as per manufacturer’s recommendations. Improvements were still required as there was no current legionella risk assessment, carried out by a competent person and the dirty / clean zones and sinks were not labelled correctly.
• There was no annual statement available in relation to infection prevention and control as required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Dental care products and medicines requiring refrigeration were stored in sealed containers in a domestic fridge. The fridge also contained a small amount of food.

There were areas where the provider could make improvements and SHOULD:

• Review availability of equipment such as an Automated External Defibrillator (AED) to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team. The provider must ensure a risk assessment is undertaken if a decision is made to not have an AED on-site.
• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the use of risk assessments to monitor and mitigate the various risks arising from undertaking of the regulated activities.
• Review the practice’s audit protocols to ensure infection control audits are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.
• Review the need for an annual statement available in relation to infection prevention and control as required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the storage of dental care products requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.