Complete Dental Care

We carried out this announced comprehensive inspection on 15 March 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 clinic appeared to be visibly clean and well-maintained.
• 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 practice had infection control procedures which reflected published guidance; however, improvements were needed to ensure audits were completed.
• Improvements were needed in relation to the practice governance arrangements.
• There were ineffective arrangements to assess and mitigate risks of fire at the practice.
• Not all risks to service users were appropriately assessed and managed.
• Dental care records we looked at were not completed in line with national guidance.
• The practice did not maintain important documents to demonstrate the X-ray equipment had received checks in line with legislation.

Background

There are three CQC registered providers operating from 200 Finchley Road, London, NW3 6BX. Two of the providers share the same location name of Complete Dental Care and are part of an expense sharing agreement partnership. Under this agreement, providers share lease costs, expenses relating to nursing and reception staff and dental equipment. The third location was not part of this agreement; instead they rented a surgery where they work from one day per week. This report relates to the provider Mrs Amanda Shaul.

Complete Dental Care is in Finchley in the London Borough of Camden. They provide private dental care and treatment for adults and children.

The practice operates from a high street property which was converted to accommodate a dental practice. There is level access into the practice for people who use wheelchairs and those with pushchairs. The practice has good links to local transportation service including London Overground Service. There is limited car parking spacing available near the practice.

The dental team includes the principal dentist, two associates and one dental hygienist. They are supported by a practice manager, two trainee dental nurses and a part time receptionist. The practice has three treatment rooms.

During the inspection we spoke with the principal dentist, an associate dentist, the trainee dental nurse, the receptionist 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 5pm

Tuesday from 8am to 4pm

Wednesday from 8am to 4pm

Thursday from 8am to 4pm

Friday from 9am to 5pm

Saturday – by appointment only.

Outside of these hours, patients are directed to NHS 111 for emergency care and treatment.

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:

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
• Improve the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.