This was a follow up inspection to see if the areas of concern found at the last inspection in February 2014 had been addressed by the provider. We had found there were gaps in how the service provided information to patients and prospective patients about the services available to them including the fees they may incur. There were minor risks to the management of infection control as staff had not followed government guidelines and disposed of single use dental equipment after use. Safe storage and management of medicines were not carried out in accordance to current good practice. There was insufficient information to show that safe and robust recruitment was carried out to ensure that appropriate skilled and experienced staff were employed. We found improvements were needed in the overall standard of record keeping. We were so concerned at how the provider managed carried out quality assurance processes including managing and learning from complaints we issued a Warning Notice to the provider. Following the inspection the provider submitted an action plan of how they intended to meet the compliance actions and Warning Notice. This visit was carried out after the provider declared they were compliant with the regulations. A Specialist Advisor came with us to help evaluate the quality of the practice.
During this inspection we wanted to assess whether patients now received treatment from a safe, effective, caring, responsive and well led service. We visited the premises, looked at the environment, reviewed five patient records, spoke with patients visiting the practice and reviewed records relating to the management of the service. We spoke with the practice manager, dental nurses, one dentist and administration staff. The practice had been without a registered manager since July 2013.
We found there remained significant risks to patients who used the service. We saw that practical improvements had been made including repairs to the electrical system and hot water for hand washing in the toilet. The provider had implemented some audit systems to monitor the quality of the service. However, we identified through investigation of complaints made to the service that patients were at considerable risk from some of the practices and the management at Duke Street Dental Practice.
Following the inspection visit on 13 May 2014 the provider company Murgelas Practice Management Ltd has been acquired by another major provider who has taken responsibility to improve the service. They have provided us with a detailed action plan as to how they intend to implement these changes. So we have taken this into consideration in regard to our next steps to ensure essential standards will be met.