The Care Quality Commission
  • Dentist
  • Dentist

Archived: Darfoor Dental

Suite V, 3rd Floor, 1 Harley Street, London, W1G 9QD (020) 7580 2294

Provided and run by:
Fraser Montague Limited

All Inspections

30 August 2017

During a routine inspection

We carried out this announced inspection on 30 August 2017 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.

This followed the inspection on 12 November 2015 that had been carried out as part of our regulatory functions where breaches of legal requirements were found. The inspection on the 30 August 2017 was a comprehensive inspection and covered all key questions because the practice had been closed for a period of time following the last inspection.

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 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

Darfoor Dental Practice is in Westminster and provides private dental implants to adults.

The dental team includes a dentist. The dentist did not employ a full-time permanent dental nurse but instead used the services of agency nurses when they had patients. On the day of the inspection they had no dental nurse booked in as there were no patients booked for treatment. The premises consists of one treatment room which that also houses the administrative area, and a dedicated decontamination area. . The practice has access to a shared waiting area that is also used by other tenants of the building it is located in.

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 Darfoor Dental Practice was the principal dentist.

On the day of inspection we collected three CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with the dentist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: 9.00 -5.30pm Monday to Friday.

Our key findings were:

  • The practice was clean.
  • The practice had infection control procedures which generally reflected published guidance.
  • The dentist knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The practice had systems to help them manage risk.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had thorough staff recruitment procedures but had not recruited any staff at the time of the inspection
  • The dentist generally provided patients’ care and treatment in line with current guidelines, although some improvements were required. .
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system met patients’ needs.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice dealt with complaints positively and efficiently.

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

  • Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
  • Review availability of medicines and equipment to manage medical emergencies taking into account guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
  • Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
  • Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
  • Review the practice’s protocols for medicines management and ensure all medicines are stored safely and securely and there is a system for identifying and disposing of out-of-date stock.
  • Review the practice’s infection control procedures and protocols to take into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’

12 November 2015

During a routine inspection

We carried out an announced comprehensive inspection on 12 November 2015 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 not providing well-led care in accordance with the relevant regulations.

Background

Darfoor Dental is located in the London Borough of Westminster and provides private dental services. The people attending the practice comprises mainly of staff from local embassies and work professionals.

The staff structure of the practice comprises of a principal dentist (who is also the owner), and dental nurses.

The premises consists of one treatment room which also houses the administrative area, and a dedicated decontamination area. . The practice has access to a shared waiting area that is also used by other tenants of the building it is located in.

The principal dentist was 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.

Before the inspection we sent Care Quality Commission (CQC) comment cards to the practice for patients to complete to tell us about their experience of the practice. We received two completed cards. They provided a positive view of the services the practice provides. Patients commented that the quality of care was good.

We carried out an announced comprehensive inspection on 12 November 2015 as part of our planned inspection of all dental practices. The inspection took place over one day and was carried out by a lead inspector and a specialist adviser. We spoke with the principal dentist on the day of the inspection. There were no patients to speak with on the day of the inspection. The principal dentist told us this was because no patients had booked appointments for this day. We spoke with the dental nurse on the phone the day after the inspection visit.

Our key findings were:

  • Patients were involved in their care and treatment planning.
  • There was appropriate equipment for staff to undertake their duties and equipment was well maintained.
  • Patients told us that staff were caring and treated them with dignity and respect.
  • There were processes in place for patients to make complaints and compliments.
  • Governance arrangements were in place and there was a clear vision for the smooth running of the practice.
  • The practice policies needed to be individualised to the practice.
  • Risks arising from lack of appropriate cleaning of used dental instruments had not been suitably identified and mitigated.
  • Clinical audits were not being undertaken appropriately and were not contributing to improvements in quality of care delivery.

We identified regulations that were not being met and the provider must:

  • Ensure an effective system is established to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.
  • Ensure the practice’s infection control procedures and protocols are reviewed giving due regard to 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’.
  • Ensure audit methodology is reviewed so learning points are documented and the resulting improvements can be demonstrated.

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

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

  • Review the storage of dental care records to ensure they were kept secure at all times

14 May 2013

During a routine inspection

We spoke with people who use the service looked at 13 feedback questionnaires that had been completed in the two months preceding our inspection. These indicated that people were satisfied with the care and treatment they had received and felt that their treatment options had been explained. One person had written "excellent, top quality service". People were also given written information.

People knew how to make a complaint and we saw the complaint's policy was on display. We asked for and received a summary of complaints people had made and the action taken by the provider. The provider was a member of the Dental Complaints Service if people were unsatisfied with the response to their complaint.

People's care and treated was planned and delivered in a way to ensure their safety by staff that had had the appropriate pre-employment checks. People were required to complete a medical history form, which was reviewed by the dentist at each appointment. There were emergency procedures and equipment in place and all staff had received basic life support training.

There were systems in place to protect people from the risk of infection. Reusable instruments were decontaminated appropriately and people who use the service observed staff wearing personal protective equipment. The provider may find it useful to not that where clinical waste was being stored was unsuitable as it was accessible to the public and pests.