Lavenham Dental Practice

We carried out this announced inspection on 4 June 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 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

Lavenham Dental Practice is in Lavenham, Suffolk and provides private treatment to adults and children.

Lavenham Dental Practice is accessed by two steps from the street level and provides dental services on the first floor of the practice. There is a single flight of stairs and this floor is not accessible for people who use wheelchairs and those with pushchairs. There is a local car park facility and parking spaces in the street.

The dental team includes one dentist, one dental nurse, a dental hygienist and the practice manager who is also a dental nurse/receptionist. The practice has one treatment room.

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.

On the day of inspection, we collected 42 CQC comment cards filled in by patients and spoke with five other patients.

During the inspection we spoke with the dentist, the dental nurse 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 from 8am to 6pm

Tuesday from 8am to 6pm

Wednesday from 8am to 6pm

Thursday from 8.30am to 4.30pm

Friday from 8am to 1pm

Our key findings were:

• Patients received their care and treatment from well-supported staff, who enjoyed their work.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. The practice was missing some essential medical emergency equipment such as some clear face masks and an automated external defibrillator (AED). The practice had a minimum supply of adrenaline and the expiry date of one medicine had not been shortened to reflect the shorter shelf life due to storage conditions. Following the inspection, the practice manager confirmed that additional adrenaline had been ordered and the missing clear face masks had been ordered.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• Not all staff recruitment procedures were in place.

• Members of the dental team were up-to-date with their continuing professional development and were supported to meet the requirements of their professional registration.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice had effective leadership and a culture of continuous audit and improvement.

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

• Review the availability of an automated external defibrillator (AED), in the practice to manage medical emergencies, taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council, and undertake a risk assessment if a decision is made not to have an AED on site.
• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice. In addition, review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.

• Review the practice’s systems for environmental cleaning taking into account the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.
• Review the practice's current performance review systems and have an effective process established for the on-going assessment and supervision of all staff.