Highfield Dental Practice

We carried out this announced focused inspection on 18 January 2023 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 practice 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 usually ask 5 key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following 3 questions were asked:

• 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:

• Cleaning throughout the practice could be improved; maintenance of dental chair covers also required attention.
• The practice had infection control procedures in place, for example in relation to decontamination of dental instruments, which reflected published guidance.
• Staff knew how to deal with medical emergencies. Some emergency medicines and items of emergency equipment were not available.
• The practice had systems to help them manage risk to patients and staff. Some of these systems had lapsed.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures in place. The documentation required to be held, which reflected current legislation, was not in place for all staff members working at the practice.
• X-ray equipment was not being managed in accordance with guidance.
• Staff provided preventive care and supported patients to ensure better oral health.
• Focus on continuous improvement was lacking and a recent turnover of staff had made it difficult to embed in daily working.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• The dental clinic had information governance arrangements.

Background

Highfield Dental Practices is in Barrow-in-Furness, Cumbria and provides private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes 4 dentists, 6 dental nurses, 4 of whom are trainees and 1 who is now the practice manager; 1 dental hygiene therapist and 3 receptionists. The practice has 5 treatment rooms.

During the inspection we spoke with 2 dentists, 2 dental nurses, 2 receptionists and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open from Monday to Friday 9am to 5.30pm.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider is not meeting are at the end of this report.

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

• 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 that staff carrying out these duties are completing tasks in line with recognised guidance and in the correct order.
• Improve the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Improve the practice’s safeguarding policy, ensuring it contains all relevant contact details of local authority safeguarding leads.