B R Davies - Mobile Dentist Also known as Mr Barry Russell Davies

We carried out a follow- up inspection at B R Davies - Mobile Dentist on the 17 October 2017.

We had undertaken an announced comprehensive inspection of this service on the 11 August 2017 as part of our regulatory functions where breaches of legal requirements were found.

After the comprehensive inspection, the practice manager wrote to us to say what they would do to meet the legal requirements in relation to the breach. This report only covers our findings in relation to that requirement.

We reviewed the practice against two of the five questions we ask about services: is the service safe and well led? You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for B R Davies - Mobile Dentist on our website at www.cqc.org.uk.

We revisited BR Davies - Mobile Dentist as part of this review and checked whether they had followed their action plan and to confirm that they now met the legal requirements. We carried out this announced inspection on 17 October 2017 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 CQC inspector who was supported by a specialist dental adviser.

• Is it safe
• Is it well-led?

This question forms the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

B R Davies - Mobile Dentist provides NHS and private domiciliary treatment to patients within Humberside and East Yorkshire. This service is provided in either a care home setting or in patients’ homes.

The dental team includes one dentist and one dental nurse.

The service 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 service is run.

During the inspection we spoke with the dentist and dental nurse.

The services are provided:

Monday – Friday 8:30am – 2pm.

Our key findings were:

• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The service had new systems to help them manage risk.
• Clinical waste was now segregated and stored appropriately.
• The service had thorough staff recruitment procedures.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Governance arrangements were now in place to support the smooth running of the service; the service was working towards auditing quality and safety

We carried out this announced inspection on 11 August 2017 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 CQC inspector who was supported by a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the service. They did not provide any information which we took into account.

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 that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

B R Davies - Mobile Dentist provides NHS and private domiciliary treatment to patients within Humberside and East Yorkshire. This service is provided in either a care home setting or in a patients home. We inspected the service from their main office and also attended a home visit to asses the service provided.

The dental team includes one dentist and one dental nurse.

The service 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 service is run.

On the day of inspection we collected five CQC comment cards filled in by patients and spoke with one other patient. This information gave us a positive view of the service.

During the inspection we spoke with the dentist and dental nurse.

The services are provided:

Monday – Friday 8:30am – 2pm.

Our key findings were:

• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The service did not have systems to help them manage risk.
• We found improvements could be made to the segregation and disposal of clinical waste in accordance with relevant regulations taking into account current guidance.
• The service had thorough staff recruitment procedures.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Governance arrangements were not in place to support the smooth running of the service; the service did not have a structured plan in place to audit quality and safety.
• The appointment system met patients’ needs.
• The service asked patients for feedback about the services they provided.
• The service dealt with complaints positively and efficiently.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation the provider was not meeting are at the end of this report.

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

• Review and implement a system to track and monitor the use of prescriptions.
• Review the risks associated with transport of contaminated instruments outside the healthcare premises taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental services and have regard to The Health and Social Care Act 2008: ‘Code of Service about the prevention and control of infections and related guidance’.
• Review the service’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies, such as Public Health England (PHE).
• Review the service's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Service regarding clinical examinations and record keeping.
• Review the service’s protocols and procedures for promoting the maintenance of good oral health taking into account guidelines issued by the Department of Health publication ‘Delivering Better Oral Health: an evidence-based toolkit for prevention’.