Elm Park Dental Clinic

We carried out this announced inspection on 29 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

Elm Park Dental Clinic is in the London Borough of Havering. The practice provides private dental treatments to adults over 18 years.

The practice is located close to public transport services. The practice is located on the ground floor of a purpose adapted building and has two treatment rooms.

The dental team includes the principal dentist, one associate dentist and one dental nurse. The principal dentist is also the practice manager.

The practice is owned by an individual who is the principal dentist there. They 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 collected feedback from 12 patients who completed CQC comment cards.

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

The practice is open between:

10am and 7pm on Mondays to Saturdays.

Our key findings were:

• The practice appeared clean.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took account of patients’ needs.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.
• Staff provided preventive care and supported patients to ensure better oral health and clinical staff provided patients’ care and treatment in line with current guidelines. Improvements were needed so that detailed records in relation to assessment, care and treatment were maintained .
• The provider infection control procedures were not consistent with published guidance.
• Staff lacked knowledge of how to deal with medical emergencies and some emergency equipment was not set up ready for use. Some items of emergency equipment were not available on the day. These were ordered and procured promptly and were available for use.
• There were ineffective systems to manage risk to patients and staff.
• Improvements were needed to the arrangements for assessing and providing adjustments to meet the needs of people with disabilities.
• There was ineffective leadership and a lack of systems to support continuous improvement.

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 regulations 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 dental dam for root canal treatment.

• Review the practice protocols regarding audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Take action to ensure the clinicians take into account the guidance provided by the Faculty of General Dental Practice when completing dental care records.