Cygnet - Advanced Beauty and Dental Clinics

We carried out this announced focused inspection on 10 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 adviser.

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

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive?
• 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 to be visibly clean and well-maintained.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health, although patients’ risk levels were not always recorded in their care records.
• Staff felt involved and supported and worked well as a team.
• Patients were asked for feedback about the services provided.
• The dental clinic had appropriate information governance arrangements in place.
• Appropriate pre-employment references and Disclosure and Barring Service (DBS) checks had not always been obtained for new staff.
• Oversight of staff training was limited, and there was no system in place to ensure all staff completed the required training.
• Overall governance systems in the practice needed to strengthen to ensure a safe service was provided.

Background

Cygnet - Advanced Beauty and Dental Clinic is based in the village of Longstanton and provides solely private dental care and treatment to adults and children. In addition to general dentistry the practice also offers dental implants. The practice is accessible for wheelchair users and car parking spaces are available on site.

The practice directly neighbours another registered dental practice owned by the provider and shares many of its procedures and governance systems. The registered manager for each practice is the same.

The dental team includes 1 dentist, a practice manager, 2 dental nurses and 1 reception staff. There is 1 treatment room.

During the inspection we spoke with a dentist, 2 dental nurses and the registered manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open on Tuesdays from 9am to 5.30pm, on Wednesdays from 8am to 7.30pm, on Thursdays from 8am to 4pm, and on Fridays from 8am to 3pm. The practice also opens on the first Saturday of the month from 8am 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:

• Take action to ensure dentists are aware of the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.

• Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records. In particular, ensuring that patients’ risk levels of caries, cancer and tooth wear is recorded, and periodontal disease is staged and graded.

• Take action to improve the auditing procedure for antimicrobial prescribing so that it is effective in assessing if clinicians are prescribing according to Faculty of General Dental Practice (UK) 2020 guidelines.