Archived: Churchfields Dental Clinic

Updated 3 March 2016

The inspection took place on the 20 January 2016 and was undertaken by a CQC inspector and a dental specialist adviser. The inspection was undertaken because we received information of concern about the service. To mitigate the risks to patients we arranged the inspection and gave short notice to the provider. As a result we were unable to send the provider comment cards ahead of the inspection for patients to complete.

The methods used to carry out this inspection included speaking with staff and reviewing policies records and documents. There were no patients booked for appointments on the day of the inspection; we were therefore unable to speak with any patients.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 3 March 2016

We carried out an announced comprehensive inspection on 20 January 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was not providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was not providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was not providing responsive care in accordance with the relevant regulations.

Are services well-led?

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

Background

Churchfields Dental Clinic is a private practice located in the London Borough of Bromley. The premises consist of one surgery, and a waiting and reception area.

The staff structure consists of one dentist and a receptionist. At the time of our inspection there was no dental nurse working in the practice and the provider was not using temporary agency staff.. At the time of our inspection the practice was only open on Tuesday and Wednesdays from 9.00am to 5.00pm.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Our key findings were:

• The practice did not have processes in place to reduce and minimise the risk of infection.
• The principal dentist was not up to date with their continuing professional development.
• The principal dentist’s registration with their professional regulator-The General Dental Council (GDC) had expired and they were currently practicing without appropriate registration.
• Patients’ needs were not assessed and treatment was not planned and delivered in line with current guidance such as from the National Institute for Health and Care Excellence.
• The practice did not have appropriate equipment and medicines to respond to a medical emergency in line with Resuscitation Council (UK) and British National Formulary (BNF) guidance
• There was lack of effective processes in place to ensure patients were safeguarded from the risks of abuse.
• The practice did not have processes in place such as undertaking audits and obtaining staff feedback to assess and monitor the quality of the service.
• The practice did not have appropriate arrangements in place to ensure that X-rays were taken safely and in line with health and safety requirements.
• The practice was not carrying out risk assessments to ensure the health and safety of staff and patients.
• The premises where the regulated activities were being undertaken was not fit for purpose.

We identified regulations that were not being met and the provider must:

• Ensure that the equipment used by the service provider for providing care or treatment to a service user is safe for such use and is used in a safe way.
• Ensure that the practice has and implements, robust procedures and processes that make sure that people are protected from abuse.
• Ensure the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed in order to meet the requirements of the regulations.
• Ensure the training, learning and development needs of individual staff members are reviewed at appropriate intervals and an effective process is established for the on-going assessment and supervision of all staff.
• Ensure audits of various aspects of the service, such as radiography, infection control and dental care records are undertaken at regular intervals to help improve the quality of service. The practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.
• Ensure the practice establishes an effective system to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.
• Ensure the safety and suitability of all areas of the premises and the fixtures and fittings.
• Ensure staff training and availability of equipment and medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Ensure the practice’s infection control procedures and protocols give due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
• Ensure that the practice is in compliance with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.
• Ensure that the registered person establishes and operates effectively an accessible system for identifying, receiving, recording, handling and responding to complaints by service users.
• Ensure the practice’s sharps handling procedures and protocols are in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2014.

The principal dentist was made aware of our findings on the day of the inspection. On the subsequent day of our inspection (21 January 2016) the provider was formally notified of our concerns.

The provider responded by submitting an application to cancel their registration with the CQC. The provider’s registration with the Care Quality Commission was cancelled on 22 January 2016 and they are no longer registered as a provider to undertake the regulated activities from this location.