High Street

We carried out this announced comprehensive inspection on 16 February 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 advisor.

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

• The dental clinic appeared generally clean. The systems to monitor and act on deterioration of the premises should be reviewed.
• Improvements were needed to ensure infection prevention and control protocols were in accordance with national guidance.
• Staff had received some medical emergency training; this did not include the range of emergencies they would need to be able to respond to. Appropriate medicines and life-saving equipment were available. The location of emergency medication and lifesaving equipment should be reviewed
• The practice did not have effective systems to manage risks for patients, staff, equipment and the premises.
• Safeguarding processes were in place. Staff received training in safeguarding vulnerable adults and children, but we were not assured this, and other learning had been implemented in the practice.
• The practice had staff recruitment procedures which reflected current legislation. These were not consistently followed.
• Systems should be reviewed to ensure patients’ care and treatment is provided and documented in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• The appointment system worked efficiently to respond to patients’ needs.
• There was a lack of leadership or culture of continuous improvement.
• Staff felt supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• The practice had systems to deal with complaints positively and efficiently.
• The practice should review disability access to ensure reasonable adjustments are in place to support patients with access requirements.

Background

The provider is part of a corporate group P.B. Robinson (Doncaster) Limited which has 7 locations registered with the CQC, and this report is about High Street.

High Street is in Bentley, Doncaster and provides NHS and private dental care and treatment for adults and children.

The practice is not accessible to wheelchairs. Wheelchair users can be accommodated at another of the provider’s nearby practices. On street parking is available near the practice.

The dental team includes 1 dentist, 1 dental nurse and 1 receptionist. The dental team is supported by a company compliance manager. The practice has 1 treatment room.

During the inspection we spoke with the dentist, the dental nurse, the receptionist and the compliance manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday 9am to 5.30pm (surgery all day)

Tuesday 9am to 5.30pm (surgery 2pm-5pm)

Wednesday 9am to 5.30pm

Thursday 9am to 5.30pm (surgery 9am-12.30pm)

Friday 9am to 5.30pm

We identified regulations the provider is 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 is not meeting are at the end of this report.