Archived: The James Street Dental Practice

We carried out this announced inspection on 08 October 2018 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 providing well-led care in accordance with the relevant regulations.

Background

The James Street Dental Practice is in Westminster and provides NHS and private treatment to patients of all ages.

The dental team includes seven dentists, four dental hygienists, three dental nurses, one trainee dental nurse, and four receptionists.  The practice has six treatment rooms, two of which are for the hygienists.

The practice is owned by a partnership 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 The James Street Dental Practice is one of the partners.

We received feedback about the practice from 14 people. During the inspection we spoke with two dentists, two dental nurses and a receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday 9am to 5.30pm
• Tuesday 8.30am to 6pm
• Wednesday 9am to 5.30pm
• Thursday 9am to 7. ppm
• Friday 9am to 5.30pm
• Saturday 9am – 1.00pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had a staff recruitment procedure but some improvements were required.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.
• The practice carried out conscious sedation for patients who would benefit. We found gaps in staff training. These were brought to the attention of the provider.

Following the inspection, the provider made the decision to stop carrying out dental procedures using conscious sedation at the practice until the training had been undertaken.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment considering guidelines issued by the British Endodontic Society.
• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting considering the guidance issued by the General Dental Council.
• Review the practice’s protocols for conscious sedation, taking into account guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015.