Thistledene Dental Practice

We undertook a follow up desk-based inspection of Thistledene Dental Practice on 23 June 2020. 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.

We undertook a comprehensive inspection of Thistledene Dental Practice on 2 October 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 safe or well led care and was in breach of regulation 12 and 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 Thistledene Dental Practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it safe?

• 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 safe?

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

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 2 October 2019.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 2 October 2019.

Background

Thistledene Dental Practice is in Poole and provides NHS and private dental treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes two principal dentists, two dental nurses, one trainee dental nurse, one dental hygienist, one practice manager and one receptionist. The practice has two treatment rooms.

The practice is owned by a partnership 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 Thistledene Dental Practice is the principal dentist. A registered manager is legally responsible for the delivery of services for which the practice is registered.

The practice is open:

• Monday to Thursday 8.00am – 5.00pm
• Friday 8.00am - 1.30pm

Our key findings were:

• The provider ensured airway protection or rubber dams were used in line with guidance.
• The provider reflected guidance with a business continuity plan, recruitment policy, mains wiring safety certificate, compressor servicing, X-ray servicing.
• The provider reflected guidance and ensured the correct emergency medical equipment and medicines were available.
• The provider ensured the correct testing regime for ultrasonic devices and that single use items were not reused in line with guidance.
• The provider reflected guidance and ensured product used are correctly assessed through HSE COSHH guidance.
• The provider provided evidence of the correct disposal of X-ray waste chemicals.
• The provider ensured that out of date materials could not be used on patients.
• The provider ensured that NHS prescriptions were accounted for.
• The provider had implemented antibiotic audits.

We are mindful of the impact of COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We carried out this announced inspection on 2 October 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 not 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

Thistledene Dental Practice is in Poole and provides NHS and private dental treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes two dentists, two dental nurses, one trainee dental nurse, one dental hygienist, one practice manager and one receptionist. The practice has two treatment rooms.

The practice is owned by a partnership 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 Thistledene Dental Practice is the principal dentist. A registered manager is legally responsible for the delivery of services for which the practice is registered

On the day of inspection, we collected 44 CQC comment cards filled in by patients and spoke with four other patients.

During the inspection we spoke with two dentists, one dental nurses, one trainee dental nurse and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Thursday 8.00am – 5.00pm
• Friday 8.00am - 1.30pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider must ensure airway protection or that rubber dams are used in line with guidance.
• The provider must reflect guidance with a business continuity plan, recruitment policy, mains wiring safety certificate, compressor servicing, X-ray servicing.
• The provider must reflect guidance and ensure the correct emergency medical equipment and medicines are available.
• The provider must ensure the correct testing regime for ultrasonic devices and that single use items are not reused in line with guidance.
• The provider must reflect guidance and ensure product used are correctly assessed through HSE COSHH guidance.
• The provider must provide evidence of the correct disposal of X-ray waste chemicals.
• The provider must ensure that out of date materials cannot be used on patients.
• The provider must ensure that NHS prescriptions are accounted for.
• The provider should implement antibiotic audits.
• The provider had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures.
• 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 supported 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:

• Ensure care and treatment is provided in a safe way to patients.
• 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:

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.