Wandsworth Town Dental Practice

We carried out this unannounced inspection on 30 July and 8 August 2018 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

Wandsworth Town Dental Practice is in the London Borough of Wandsworth and provides NHS and private treatment.

There is level access for people who use wheelchairs and those with pushchairs.

The dental team includes seven dentists, seven dental nurses and two trainee dental nurses. The dental nurses also provided reception duties.

The practice has four 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 Wandsworth Town Dental Practice was the principal dentist.

On the day of inspection, we spoke with three patients.

During the inspection we spoke with two dentists, two of the dental nurses, a receptionist 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-Friday 9am – 5.30pm

Saturday 9am–4pm

Sunday 11am–3pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures, however they did not fully reflect published guidance.
• Emergency medicines and life-saving equipment as per national guidance were available, though there were some gaps..
• The practice had systems to help them manage risk.
• The practice did not have suitable safeguarding processes and not all staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures however, there were gaps in checks undertaken.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• The practice was providing preventive care and was supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice asked staff and patients for feedback about the services they provided.
• The practice did not demonstrate effective leadership.
• The practice did not have suitable information governance arrangements.
• Systems were not in place to assess, monitor and improve the quality of the service.

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

• Ensure suitable processes are in place for safeguarding people from abuse.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
• Ensure specified information is available regarding each person employed

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

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

• Review its responsibilities to respond to the needs of patients with disability and the requirements of the Equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.
• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice's protocol and staff awareness of their responsibilities under the Duty of candour to ensure compliance with The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.