We carried out an announced comprehensive inspection on 20 December 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well led?
Our findings were:
Are services safe?
We found that this practice was not 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
The Cambridge Smile Studio is a well-established dental practice that provides mostly NHS general dentistry services to adults and children. It is situated near Cambridge City Centre and serves about 10,000 patients.
The practice has a team of five dentists, three hygienists, a practice manager, seven dental nurses and reception staff. There are six treatment rooms, a room for the decontamination of instruments, an office, and a reception and waiting area. A specialist dentist visits once a month to provide implants to patients.
The practice opens on Mondays from 8am to 7pm, and on Tuesdays to Fridays from 8am to 5pm.
The practice owner is registered with the Care Quality Commission (CQC) as the registered manager. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.
Our key findings were:
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- Patients received clear explanations about their proposed treatment and were actively involved in making decisions about it. They were treated in a way that they liked by staff
- Staff had received safeguarding training and took good action to protect vulnerable adults and children when needed.
- Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.
- Appointments were easy to book and emergency slots were available each day for patients requiring urgent treatment.
- Staff were not aware of recent safety alerts from the Medicines and Healthcare products Regulatory Agency (MHRA) that affected dental practice.
- Arrangements for monitoring safety and managing risk were not robust. This included the recording of significant events, assessing potential hazards and the use of a safer sharps’ system.
- The practice’s recruitment process did not ensure that all relevant checks were undertaken before new staff started work.
- Communication systems within the practice were poor and not all staff felt supported or valued in their work.
We identified regulations that were not being met and the provider must:
- Ensure robust systems are in place so that care and treatment is provided in a safe way for patients. This includes implementing processes for reporting, recording and monitoring significant events; responding to national patients safety alerts; ensuring staff recruitment procedures are robust; ensuring the practice’s sharps handling procedures and protocols are in compliance with national guidelines, and ensuring infection control audits are undertaken at regular intervals.
- Ensure effective systems and processes are established to assess and monitor the service against the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and national guidance relevant to dental practice. This includes providing staff with adequate supervision and appraisal, auditing the quality of the service provided, ensuring policies and procedures are kept up to date and followed, and providing clear leadership within the practice.
There were areas where the provider could make improvements and should:
- Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
- Review the availability of an interpreter service for patients who do not speak English as their first language.
- Review the storage of dental care products and medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.