Archived: Dentaris Ltd

We undertook a follow up inspection of Dentaris Ltd on 25 November 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

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

We undertook a comprehensive inspection of Dentaris Ltd on 29 July 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well-led care and was in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Dentaris Ltd on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

Our findings were:

Are services well-led?

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

The provider had made insufficient improvements to put right the shortfalls and had not responded to the regulatory breach we found at our inspection on 29 July 2019.

Background

Dentaris Ltd is in Grimsby and provides NHS and private treatment to adults and children. There is also a separate premises at 12 Cleethorpe Road where there is a cone beam computed tomography machine and office space.

There is level access at the rear of the premises for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes two dentists, three trainee dental nurses, two dental hygiene therapists, one receptionist and a trainee practice manager. Many of the staff had started within the previous month. The practice has two treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Dentaris Ltd is one of the dentists.

During the inspection we spoke with the registered manager, one dental hygiene therapist and the trainee practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Wednesday from 8:30am to 5:00pm

Thursday from 8:15am to 6:15pm

Friday from 8:15am to 2:15pm

Our key findings were:

• Medical emergency equipment was available as described in nationally recognised guidance.
• Improvements had been made to the process for managing the risks associated with the use of X-rays.
• Improvements could be made to the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term. These include the monitoring of staff training, evidence of valid indemnity and the risks associated with fire and Hepatitis B.

We identified regulations the provider was not meeting. They must:

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

Full details of the regulation the provider was not meeting are at the end of this report.

We carried out this announced inspection on 29 July 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 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 that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was 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

Dentaris Ltd is in Grimsby and provides NHS and private treatment to adults and children. There is also a separate premises at 12 Cleethorpe Road where there is a cone beam computed tomography machine and office space.

There is level access through the back door for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes three dentists, five dental nurses (two of whom are trainees), a dental hygienist and therapist and a practice manager. The practice has two treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Dentaris Ltd is the clinical director.

On the day of inspection, we collected 41 CQC comment cards filled in by patients.

During the inspection we spoke with one dentist, three 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:

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. On the day of inspection not all medical emergency equipment was available as described in nationally recognised guidance. The missing items were ordered and evidence was sent after the inspection.
• Improvements could be made to the systems for managing the risks associated with carrying out the regulated activities. This included the risks associated with fire and radiation.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures. Improvements could be made to the process for maintaining up to date documentation relating to staff working within the practice.
• The clinical staff provided 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.
• Staff provided preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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.

Full details of the regulation the provider was not meeting are at the end of this report.