Updated 28 February 2020
We carried out this announced inspection on 3 December 2019 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 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:
Are services safe?
We found this practice not providing safe care in accordance with the relevant regulations.
Are services effective?
We found this practice not providing effective care in accordance with the relevant regulations.
Are services caring?
We found this practice was not providing caring services in accordance with the relevant regulations.
Are services responsive?
We found this practice was not providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found this practice not providing well-led care in accordance with the relevant regulations.
Background
Dr Julian Bone – North Lodge is in Maidstone 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. Car parking spaces, including dedicated parking for people with disabilities, are available on the practice premises.
The dental team includes a dentist, and two dental nurses who share reception duties. The practice has one treatment room.
The practice is owned by an individual who is the principal dentist. 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.
On the day of inspection, we collected 12 CQC comment cards filled in by patients and spoke with three other patients.
During the inspection we spoke with the dentist, and both dental nurses. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday to Wednesday 9am to 5pm
Thursday closed
Friday 9am to 1pm
Weekends closed
Our key findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures which did not reflect published guidance.
- Staff did not have sufficient knowledge on how to deal with emergencies. Appropriate medicines and life-saving equipment were not all available.
- The provider did not have sufficient systems to help them manage risk to patients and staff.
- The provider did not have safeguarding processes and staff were not sure of their responsibilities for safeguarding vulnerable adults and children.
- The provider did not have staff recruitment procedures which reflected current legislation.
- The clinical staff did not provide 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. Although improvements need to be made with regard to GDPR
- Staff did not provide preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- There was not a culture of continuous improvement.
- Staff told us they felt involved and supported and worked as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider did not have information governance arrangements.
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
Significant failings where found at this inspection and we are therefore taking action in line with our enforcement procedures to prevent the provider from operating this service.