Hillcrest Dental

We carried out this announced focused inspection on 12 July 2022 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 five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three 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:

• The dental clinic was visibly clean.
• The practice had infection control procedures which reflected published guidance. However, improvements could be made.
• Staff knew how to deal with medical emergencies.
• The practice had systems to help them manage risk to patients and staff. Improvements could be made in relation to reduction of fire risk.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines. An antimicrobial audit is recommended to improve practice.
• Patients were treated with dignity and respect and staff 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.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The dental clinic had information governance arrangements.

Background

Hillcrest Dental Practice is in Barnstaple and provides private dental care to mostly adults.

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

The dental team includes two dentists, one dental nurse, one dental hygienist, one receptionist, two administrators and a practice manager/dental nurse. The practice has three treatment rooms (two are currently in use). One of the treatment rooms in located on the ground floor.

During the inspection we spoke with the principal dentist, the dental hygienist, two dental nurses (one of whom was a locum nurse), one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 9am – 5pm.

(The practice is closed for lunch between 1pm – 2pm).

The practice had taken steps to improve environmental sustainability. For example, the practice used an intra oral camera, microscope and intra oral scanner. These are cleaner technologies, which also allow diagnoses to take place at the practice, reduces dental waste patient travelling.

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

• Take action to ensure ongoing fire safety management is effective.
• Implement audits for prescribing of antibiotic medicines, taking into account the guidance provided by the College of General Dentistry.
• 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, by establishing a clear date for upgrading the current temporary decontamination and sterilising of dental instruments room.