Harrison Dental

We carried out this unannounced focused inspection on 21 June 2022 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 usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental practice was visibly clean and well-maintained.
• The practice had infection control procedures which did not reflect published guidance.
• Staff knew how to deal with medical emergencies. Some appropriate medicines and life-saving equipment were available. However, some items were missing or beyond their use by date.
• Systems to help the practice manage risk to patients and staff need to be reviewed and improved.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• 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.
• The appointment system took account of patients’ needs.
• The dental clinic had information governance arrangements.
• The system of audits completed at the practice need improving to ensure learning and continuous improvement.
• Leadership, oversight and management was lacking and required improvement
• Systems to provide staff support needed improvement.

Background

Harrison Dental is in central Nottingham and provides private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice.

The dental team includes three dentists, three dental nurses, and a care co-ordinator. The practice has two treatment rooms.

During the inspection we spoke with two dentists, one dental nurse and the care co-ordinator. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday from 10am to 5pm

Tuesday from 9am to 5pm

Wednesday, Thursday, Friday from 9am to 6pm

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 is at the end of this report.

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

• Improve the practice's systems for checking and monitoring appliances taking into account relevant guidance and ensure that all appliances are well maintained. In particular ensure that copies of the five-year fixed wire electrical safety check and the annual gas safety check were held within the practice.

• Develop systems to ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff. Including the training, learning and development needs of individual staff members at appropriate intervals. In addition, implement practice protocols and procedures to ensure staff are up to date with their mandatory training and their continuing professional development.

• Improve and develop the practice's current performance review systems and have an effective process established for the on-going assessment and supervision of all staff.