Cheriton Dental Practice

We carried out this announced inspection on 27 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, (CQC), 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 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 providing well-led care in accordance with the relevant regulations.

Background

Cheriton Dental Practice is in Christchurch and provides private dental care and treatment for adults and NHS dental care and treatment for 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 five dentists, 14 dental nurses, one trainee dental nurse, one decontamination technician, six dental hygienists, two receptionists and a practice manager. The practice has five treatment rooms.

The practice is owned by a partnership 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 Cheriton Dental Practice was the practice manager. A registered manager is legally responsible for the delivery of services for which the practice is registered.

On the day of inspection, we collected nine CQC comment cards filled in by patients and spoke with four other patients.

During the inspection we spoke with three dentists, six dental nurses, one trainee dental nurse, two dental hygienists, one 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 8.30am to 6.30pm
• Tuesday and Wednesday 8.30am to 5.30pm
• Thursday 8.30am to 9.30pm
• Friday 8.30am to 5pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• Improvements should be made to the sequence of cleaning and storage of instruments; and tidiness of the decontamination rooms.
• Improvements should be made to ensure that availability of appropriate medicines and life-saving equipment is in line with guidance.
• Improvements should be made to the management of sharps.
• Improvements should be made to the management of substances that fall under the Control of Substances Hazardous to Health (COSHH) Regulations 2002.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• 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:

• Improve the practice's processes for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and substances are stored securely.

• Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ in particular the sequence of manual and automated cleaning, and the storage of instruments; and tidiness of decontamination rooms.

• Improve the practice’s sharps procedures to ensure the practice complies with Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

• Take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.