Updated 14 March 2023
We carried out this announced comprehensive inspection on 14 February 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 advisor.
To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:
- The dental clinic appeared clean and tidy.
- The practice had infection control procedures which reflected published guidance. One of the daily checks on sterilising equipment was not being completed in accordance with guidance.
- Staff knew how to deal with medical emergencies.
- Medicines and life-saving equipment were available; we found 3 recommended items were not available.
- The practice had systems to manage risks for patients, staff, equipment and the premises. Some identified action points from independent risk assessments had yet to be addressed.
- 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.
- Clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system worked efficiently to respond to patients’ needs.
- The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
- There was effective leadership; staff worked together to ensure the needs of patients were met.
- Staff felt involved, supported and worked as a team.
- Systems were in place to ensure complaints could be dealt with positively and efficiently.
- The practice had information governance arrangements.
Background
Dr N H Gokul practice is in Morecambe, Lancashire and provides largely NHS and some private dental care and treatment for adults and children.
There is no step free access to the practice for people who use wheelchairs and those with pushchairs. For patients with reduced mobility, we saw a stair lift was available for use. Car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with access requirements, for example the installation of a portable hearing loop.
The dental team includes 2 dentists, 3 dental nurses, a practice administrator/manager and a receptionist. The practice has 4 treatment rooms, 3 of which are in daily use.
During the inspection we spoke with the principal dentist, a dental nurse, a receptionist and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open: 9am to 5.30pm Monday to Friday.
There were areas where the provider could make improvements. They should:
- Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
- Take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
- Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, that the required actions from independent risk assessments are acted on.
- 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 all tests on equipment are carried out in accordance with guidance.