Mr Philip Chai Kee Wee

We carried out this announced inspection on 26 November 2021 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 usually ask five key questions. However, due to the ongoing 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 are three of the five questions that form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services well-led?

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

Background

Mr Philip Chai Kee Wee is a family run dental practice is in the London Borough of Camden and provides NHS and private dental care and treatment for adults and children.

The practice is located on the first and second floors of a Victorian building which is accessed via a side entrance door. The practice was not suitable for those people who use wheelchairs and those with pushchairs; patients are made aware of this when they telephone to register. Paid car parking spaces are available near the practice.

The dental team includes the principal dentist and a dental nurse who also undertakes receptionist duties. The practice has two treatment rooms, however only one is viable and functional. There is a patient waiting area and a separate decontamination room.

The practice is owned by an individual who is the principal dentist there. 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. They are registered to provide the regulated activities of treatment of disease, disorder or injury, surgical procedures and diagnostic and screening procedures from one location.

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

The practice is open Monday to Friday 10am to 5pm. Outside of these hours, patients are advised to contact NHS 111 for emergency care and treatment.

Our key findings were:

• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures which reflected current legislation.
• Clinical waste was disposed of suitably.
• The dental team was long-standing which meant there was continuity of care and treatment for patients.
• The practice needed redecoration, refurnishing and general refurbishment.
• The treatment room which was used to deliver care and treatment appeared visibly clean.
• Improvements were needed in relation to fire safety, referrals monitoring and prescription management.
• Not all risks to service users were appropriately assessed and managed.
• The practice had some policies and procedures to govern activities.
• Most equipment were serviced as per manufacturer’s guidance.
• The practice did not have effective systems to keep dental professionals up to date with current evidence-based practice.
• Dental care records we checked were not completed as per recommended guidance.

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

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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 dentist is aware of the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.