We carried out this announced inspection on 2 September 2021 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 asked the following three questions:
• 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.
Are services well-led?
We found this practice was not providing well-led care in accordance with the relevant regulations.
Background
Bath Street Dental Practice provides NHS and private dental care and treatment for adults and children.
The practice treatment rooms are based on the first and second floor of the practice. New patients who find stairs a barrier are advised of this when they contact the practice.
There are no specific patient car parking spaces at the practice. However, there is parking available nearby the practice.
The dental team includes four dentists, one dental hygiene therapist, five dental nurses, one receptionist and a practice manager. The practice has three treatment rooms.
The practice is owned by an organisation 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 Bath Street Dental Practice is the principal dentist.
During the inspection we spoke with two dentists, two dental nurses, the receptionist and 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 5.30pm
- Tuesday 8.30am to 5.30pm
- Wednesday 8.30am to 7.30pm
- Thursday 8.30am to 5.30pm
- Friday 8.30am to 4.30pm
.
Our key findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. All but one emergency medicine was available.
- Private patient referrals to other health providers were not monitored to ensure they were received in a timely way.
- The provider had systems to help them manage risk to patients and staff.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- Antibiotic prescribing audits were not carried out.
- The provider had staff recruitment procedures which reflected current legislation, but improvements were needed.
- The clinical staff provided patients’ care and treatment in line with current guidelines but not all clinicians maintained detailed patient treatment care records.
- The provider had information governance arrangements and took care to protect their privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- 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.
We identified regulations the provider was not complying with. They must:
- Improve the practice's recruitment procedures to ensure accurate, complete and detailed records are maintained for all staff.
There were areas where the provider could make improvements. They should:
- Implement audits for prescribing of antibiotic medicines considering the guidance provided by the Faculty of General Dental Practice.
- Implement a system to ensure patient referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner and not lost.
- Take action to ensure the availability of Glucagon in the practice to manage medical emergencies taking into account the guidelines issued by the British National Formulary and the General Dental Council.
- Improve the practice protocols regarding patient dental care records for one clinician to check that necessary information is recorded.
- Take action to ensure surgery drawers are audited regularly to remove out of date materials and equipment.