Fulham Dental Care

We carried out this announced comprehensive inspection on 11 January 2023 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 advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:

• The dental clinic appeared clean and well-maintained.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• Staff felt involved, supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• Improvements were needed to the systems to help the provider manage risk to patients and staff.
• The practice had staff recruitment procedures which reflected current legislation; however, some staff records were incomplete on the day of inspection.
• There were ineffective systems to support continuous improvement
• Staff knew how to deal with medical emergencies. However, not all of the life-saving equipment was available as per national guidelines. Following the inspection, the provider took timely action to rectify this.
• The leadership and oversight for the day-to-day management of the service needed improvements.
• The practice did not have infection control procedures which reflected published guidance

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Background

Fulham Dental Care is in the London Borough of Hammersmith and Fulham and provides private dental care and treatment for adults and children.

The practice is within a building comprising of 3 split-levels and access to treatment rooms require the navigation of a few steps. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 3 dentists, an orthodontic specialist, 2 dental nurses, a dental hygienist, a practice manager and a receptionist. The practice has 3 treatment rooms.

During the inspection we spoke with the principal dentist, an associate dentist, a locum dental nurse and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday & Thursday 10am to 7pm

Tuesday & Wednesday 9am to 6pm

Friday 9am to 4.30pm

Saturday 9.30am to 3pm

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.

There were areas where the provider could make improvements. They should:

• Improve the practice's protocols for medicines management and ensure all medicines are dispensed of safely taking into account the guidance provided by the College of General Dentistry (CGDent).
• Improve the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular with regard to lone working.
• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
• Implement protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.