Archived: Redbourn Dental Practice

Updated 4 May 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We carried out an announced, comprehensive inspection on 8 March 2016. The inspection team consisted of a Care Quality Commission (CQC) inspector and a dental specialist advisor.

Before the inspection we asked the for information to be sent, this included the complaints the practice had received in the last 12 months; their latest statement of purpose; the details of the staff members, their qualifications and proof of registration with their professional bodies. We spoke with five members of staff during the inspection.

We also reviewed the information we held about the practice and found there were no areas of concern.

During the inspection we spoke with two dentists, and two dental nurses and a receptionist. We reviewed policies, procedures and other documents. We received feedback from 49 patients about the dental service.

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 4 May 2016

We carried out an announced comprehensive inspection on 8 March 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 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 providing well-led care in accordance with the relevant regulations.

Background

Redbourn Dental Practice is situated over three floors of a converted building on the High Street of Redbourn, a village near to St Albans in Hertfordshire. The practice was registered with the Care Quality Commission (CQC) in July 2011. The practice provides regulated dental services to patients from Redbourn and the surrounding area. The practice provides mostly private dental treatment. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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.

We received positive feedback from 49 patients about the services provided. This was through CQC comment cards left at the practice prior to the inspection and by speaking with patients in the practice.

Our key findings were:

• Staff treated patients with care and compassion; patients commented that if nervous they were made to feel at ease.
• The practice met the essential standards in infection control and cleanliness documented in the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05).
• Treatment options were identified, explored and discussed with patients.

• Staff demonstrated a good knowledge of how to raise a safeguarding concern, and the situation in which that may be required.

• Patients’ confidentiality was maintained.

• The practice had policies in place to maintain the smooth running of the service.

• Dentists used nationally recognised guidance to aid in the care and treatment of patients.

• Governance protocols to ensure the continuing improvement of the service were not as robust as they could be. Certain required clinical audit and risk assessments had not been completed such as the quality of radiographs, and a legionella risk assessment.

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There were areas where the provider could make improvements and should:

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review availability and storage of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), the British National Formulary and the General Dental Council (GDC) standards for the dental team.

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society

• Review the need for a legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the 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

• Establish whether the practice is in compliance with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IR(ME)R) 2000 and review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray.

• Review the practice’s governance protocols and procedures regarding completing clinical audit of various aspects of the service, and ensuring staff are up to date with their mandatory training and their Continuing Professional Development. Practice should also check all audits and risk assessments have documented learning points and action plans.