Updated 19 November 2021
We carried out this announced inspection on 1 October 2021under 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, (CQC), inspector who was supported by a specialist dental adviser.
As part of this inspection we 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:
Are services safe?
We found this practice was 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.
regulations.
Are services well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
Background
Red Lodge Dental Surgery is in the village of Red Lodge, between Mildenhall and Newmarket, Suffolk and provides NHS and 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 people with disabilities, are available outside the practice.
The dental team includes four dentists, a visiting orthodontist, four dental nurses, three trainee dental nurses, two dental hygienists, the practice manager (who is a qualified dental nurse), four receptionists and a cleaner. The practice has five treatment rooms.
The practice is owned by a company and as a condition of registration must have a person registered with the CQC as the registered manager. Registered managers 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 registered manager at Red Lodge Dental Surgery is the practice manager.
During the inspection we spoke with two dentists, three dental nurses, two receptionists, the provider/owner 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 and Thursday from 9am to 6pm.
Tuesday and Wednesday from 9am to 5.30pm.
Friday from 9am to 4pm.
Our key findings were:
- Premises and equipment were clean and properly maintained and the practice followed national guidance for cleaning, sterilising and storing dental instruments. However, we noted five-yearly electrical fixed wire testing had not been undertaken.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Not all appropriate medicines and life-saving equipment were available. The practice took immediate action to rectify this.
- The provider had systems to help them manage risk to patients and staff.
- Audits of antimicrobial prescribing were not undertaken.
- The recording of staging and grading of periodontal (gum) disease in patients dental care records was not always completed. The clinicians had not always justified dental X-rays in the dental care records.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. However, not all staff were aware of safeguarding contact information.
- The provider had staff recruitment procedures which reflected 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 dealt with complaints positively and efficiently.
- The provider had information governance arrangements.
There were areas where the provider could make improvements. They should:
- Implement an effective system of checks of medical emergency equipment and medicines taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
- Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice and improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
- Take action to ensure the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular ensure the five-yearly electrical fixed wire testing is undertaken.