Ardleigh Green Dental Clinic

We carried out this announced focused inspection on 26 April 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 usually ask five key questions, however due to the ongoing COVID-19 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:

• The dental clinic was visibly clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies; however, buccal midazolam was not available on the day.
• The systems to manage risk to patients and staff needed improvement.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation; however, this was not always followed when recruiting new staff members.
• Improvements were needed in relation to the practice governance arrangements.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• X-ray equipment had not received routine radiological tests as per recommended guidance.
• Complaints were dealt with positively and efficiently.
• The dental clinic had information governance arrangements, however, this needed strengthening to ensure all areas were covered appropriately.
• Audits were not undertaken at regular intervals to improve the quality of the service.

Background

The provider has one practice and this report is about Ardleigh Green Dental Clinic.

Ardleigh Green Dental Clinic is in the London Borough of Havering; North East London. The practice provides NHS and private dental care and treatment for adults and children.

The practice is easily accessible by local transportation including London Underground. It does not have a car park, however, there is permit free parking on surrounding streets. The practice consists of three treatment rooms, reception and waiting area, a toilet and a kitchen/office area. There is level access to the practice for people who use wheelchairs and those with pushchairs.

The dental team includes the principal dentist, an associate dentist, a visiting specialist oral surgeon who places implants, three dental nurses, a dental hygienist and a receptionist. They were supported by a full-time practice manager.

During the inspection we spoke with the principal dentist, two dental nurses, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday to Friday 9:00 am to 5:30 pm; closing between 1:00pm and 2:00pm for lunch. Outside of these hours, patients are advised to contact the NHS 111 service for urgent care and treatment.

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.

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 the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.

• Consider implementing audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.

• Implement processes and systems for seeking and learning from staff feedback with a view to monitoring and improving the quality of the service.

• Improve the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term.