21 March 2022
During an inspection looking at part of the service
We carried out this announced focused inspection on 21 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:
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The dental clinic was visibly clean, but improvements could be made by the introduction of cleaning schedules to cover all areas of the practice.
- The practice had infection control procedures in place, improvements could be made to some procedures to reflect current guidance.
- Staff knew how to deal with emergencies, but the system for ensuring the availability of medical emergency equipment was not effective.
- The practice had good systems to help them manage risk to patients and staff, improvements could be made to the fire assessment and the provision of emergency lighting.
- 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.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- The dental clinic had information governance arrangements.
Background
The provider has two practices and this report is about Azam and Associates Healthcare Ltd in Halifax, which provides NHS and private dental care and treatment for adults and children.
There is level access to the practice (via a portable ramp) for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.
The dental team includes four dentists, five dental nurses/receptionists and a practice manager. The practice has four treatment rooms.
During the inspection we spoke with two dentists, two dental nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
9am-5:30pm
There were areas where the provider could make improvements. They should:
- Take action to review the fire risk assessment and the provision of emergency lighting to ensure ongoing fire safety management is effective.
- Implement an effective system of checks of medical emergency equipment and review staff training.
- Improve the practice’s infection control procedures and protocols.
- Review audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.