Updated 21 April 2020
We undertook a follow up desk-based inspection of Lynwood Dental Practice on 26 March 2020. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.
The inspection was led by a CQC inspector.
We undertook a comprehensive inspection of Lynwood Dental Practice on 15 October 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well-led care and was in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Lynwood Dental Practice on our website www.cqc.org.uk.
As part of this inspection we asked: Remove as appropriate:
• Is it well-led?
When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.
Our findings were:
Are services well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
The provider had made improvements in relation to the regulatory breach we found at our inspection on 15 October 2019.
Background
Lynwood Dental Practice is in Hightown, Merseyside and provides NHS and private treatment to adults and children.
There is level access for people who use wheelchairs and those with pushchairs. Car parking is available near the practice. The ground floor surgery is accessible for wheelchair users.
The dental team includes two dentists, five dental nurses, three of whom are trainees, and two dental hygiene therapists. The practice has two treatment rooms.
The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
For this inspection we spoke with the principal dentist. We also reviewed changes made to practice policies and procedures and other records about how the service is managed.
The practice is open: Monday to Thursday 9am to 6pm and on Friday from 9am to 5pm.
Our key findings were:
- The infection audit control tool used by the practice was now the updated version which included a statement of any actions required. Staff had been encouraged to complete this to ensure any required actions were identified and recorded.
- All appropriate medicines and life-saving equipment were available, as described in recognised guidance. The list used to check medicines and equipment against had been updated. Glucagon was being stored in the fridge and the temperature of the fridge was monitored daily.
- The provider had systems to help them manage risk to patients and staff. These had been reviewed with staff. For example, staff were told that they should not be dismantling any sharps, including matrix bands.
- All required recruitment records were in place for all staff working at the practice. A training matrix was now in place to give the provider oversight of any staff training requirements.
- A Legionella risk assessment had been booked for the practice, following changes to the building, for example, the provision of a new toilet facility. This assessment had been postponed due to the Corona virus outbreak. Paperwork from the risk assessor was provided to demonstrate that all reasonable steps had been taken and that a full assessment would be carried out as soon as this was permitted.
- There was a system in place to monitor referrals to specialist or secondary care. All staff were familiar with this so they could make checks in the absence of any colleague.
- The complaints procedure had been reviewed and updated to ensure this met the guidance on NHS complaints handling and protocol.
- Clinical waste audits were in place.
- Policies had been reviewed and staff were updated on changes made to these.
- The system for receiving alerts and updates in the practice had been reviewed and updated to ensure staff had access to these and that they were printed off for staff to refer to.