Broughton Dental Practice Limited

We carried out this announced inspection on 30 September 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 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 that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Broughton Dental Practice is in Broughton Astley, a large village located in the Harborough district of Leicestershire. It provides private dental treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs through entry at the rear of the premises. There are some limited car parking spaces at the front of the premises and free public car parking is also available on street within close proximity.

The dental team includes two dentists, two dental nurses, one trainee dental nurse, two dental hygienists, one dental hygiene therapist, one clinical dental technician, two receptionists and a practice manager. The practice has three treatment rooms, one is located on the ground floor.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Broughton Astley Dental Practice is the principal dentist.

On the day of inspection, we collected 27 CQC comment cards filled in by patients.

During the inspection we spoke with one dentist, two dental nurses (including the trainee), the dental hygiene therapist, the clinical dental technician, one receptionist and the practice manager. We looked at practice policies and procedures, patient feedback and other records about how the service is managed.

The practice is open: Monday, Wednesday, Thursday and Friday from 8.30am to 4.30pm and Tuesday from 8.30am to 7pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and most life-saving equipment were available with some exceptions. For example, size 0 oropharyngeal airways, a child self-inflating bag with reservoir and the clear face masks for self-inflating bag were not available. Items were purchased after the day of inspection.
• The practice’s systems to help them manage risk to patients and staff required review as some were ineffective. Risks were not mitigated in relation to issues such as five-year fixed wiring testing, gas safety testing, lone working and sharps.
• The provider had safeguarding processes, although we were not assured that some members of the team had completed safeguarding training within the previous three years at the time of our visit.
• The provider’s staff recruitment procedures required review as they were not compliant with legislative requirements.
• The clinical staff provided patients’ care and treatment in line with current guidelines. We found that further detail was required in some aspects of record keeping.
• 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.
• Staff felt involved and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• Governance arrangements required strengthening.

We identified regulations the provider was not complying with. They must:

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

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

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

• Take action to ensure the service takes into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.
• Improve and develop staff awareness of Gillick competence and the requirements of the Mental Capacity Act 2005 and ensure all staff are aware of their responsibilities as it relates to their role.
• Take action to ensure the clinicians take into account the guidance provided by the Faculty of General Dental Practice when completing dental care records.