Highgrove Dental Care

We undertook a follow-up desk based focused review of Highgrove Dental Care on 6 August 2020.

This review was carried out to assess the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The review was carried out by a CQC inspector who had remote access to a specialist dental adviser.

We undertook a comprehensive inspection on 19 November 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well-led care and was in breach of Regulations 15, 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can read our report of that inspection by selecting the link for Highgrove Dental Care on our website www.cqc.org.uk.

When one or more of the five questions are not met, we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

This desk-based review was undertaken during the Covid 19 pandemic.

Due to the demands and constraints in place because of Covid 19 we reviewed the action plan and asked the provider to confirm compliance after a reasonable interval, focusing on the areas where improvement was required.

As part of this review we asked:

• Is it Safe?

• Is it well-led?

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations. The provider had made improvements in relation to the regulatory breaches we found at our inspection on 19 November 2019.

well-led?

We found this practice was providing well-led care in accordance with the relevant regulations. The provider had made improvements in relation to the regulatory breaches we found at our inspection on 19 November 2019.

Background

Highgrove Dental Care is in Reading and provides NHS and private dental care and treatment for adults and children. There is level access to the practice, via a ramp, 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 two dentists, two dental nurses, one dental hygienist and a receptionist. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist. 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.

The practice is open:

• Monday, Wednesday, Thursday and Friday 8.00am to 4.00pm

• Tuesday 10.00am to 7.00pm.

Our key findings were:

• The provider ensured that the premises used by the service were properly maintained.

• Systems and processes were put in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk.

• Recruitment procedures were established to ensure only fit and proper persons are employed.

We carried out this announced inspection on 19 November 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 Care Quality Commission 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 this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Highrove Dental Care is in Reading and provides NHS and private dental care and treatment for adults and children.

There is level access to the practice, via a ramp, 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 two dentists, two dental nurses, one dental hygienist and a receptionist. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist. 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 44 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with two dentists, two dental nurses and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday, Wednesday, Thursday and Friday 8.00am to 4.00pm
• Tuesday 10.00am to 7.00pm.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance but improvements were needed.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The provider had systems to help them manage risk to patients and staff but improvements were needed.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider did not operate staff recruitment procedures in line with current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and 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 provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had systems in place to deal with complaints efficiently.
• The practice did not have effective management leadership.

We identified regulations the provider was not complying with. They must:

• Ensure all premises and equipment used by the service provider is fit for use. In particular, emergency lighting provision and testing; and portable appliance and fixed wiring electrical safety.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. Specifically, management of infection control, sharps and medicines.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

Full details of the regulations the provider is not meeting are at the end of this report.

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Take action to ensure the service takes into account the needs of disabled people and to comply with the requirements of the Equality Act 2010. Specifically, arrangements to support patients who experience hearing loss.