We carried out this announced focused inspection on 16 August 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 and well-maintained.
- The practice had infection control procedures in place; these did not fully reflect recognised guidance.
- Staff knew how to deal with medical emergencies. Some items recommended to be held as part of emergency life-saving equipment were not available, and one of the medicines held was not in the correct format.
- The practice had systems to help them manage risk to patients and staff. Knowledge of and adherence to these systems was insufficient; some practice policies to support staff safety were out of date.
- Safeguarding processes were in place for child safeguarding. There was no protocol or policy in place for staff to refer to for adult safeguarding concerns.
- The practice did not have staff recruitment procedures and processes in place which reflected current legislation.
- The clinical staff provided patients’ care and treatment in line with current guidelines. Governance in the issuing of medicines to patients and provision of information to patients receiving medicines required greater oversight and management.
- 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.
- Staff worked as a team to ensure patients experienced a good standard of care.
- The dental clinic had information governance arrangements.
Background
Benson Street Dental and Beauty is in Ulverston, Cumbria and provides private dental care and treatment for predominantly adults. It does provide services to children as and when requested.
Entry to the practice is via two flights of stairs. The practice is not accessible to those with mobility issues.
Car parking spaces, including dedicated parking for disabled people, are available near the practice in pay and display car parks.
The dental team includes three dentists, one of whom undertakes orthodontic treatment, four dental nurses, one of whom is a trainee, one dental hygienist, two decontamination room technicians, one of whom also works on reception, one practice co-ordinator, a receptionist and the practice manager. The practice has two treatment rooms and one beauty room.
The Care Quality Commission (CQC) does not regulate the beauty treatments provided by this practice and as such, this inspection report does not comment on beauty treatments provided by the practice.
During the inspection we spoke with the principal dentist, the dental hygienist, one receptionist, a decontamination room technician, 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 8am to 4pm; Tuesday 8.30am to 5.30pm; Wednesday 8am to 5pm; Thursday 8.30am to 5.30pm; and on Friday 8am to 4pm. The practice opens approximately two Saturdays per month, based on patient need, when the practice will open from 8am to 12pm.
We identified regulations the provider was not complying with. They must:
- Ensure care and treatment is provided in a safe way to patients
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
Full details of the regulation the provider was not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Improve the practice's waste handling protocols to ensure waste is segregated and disposed of in compliance with the relevant regulations and taking into account the guidance issued in the Health Technical Memorandum 07-01.
- 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.