Archived: Blue Cross Dental Care

We carried out this announced focussed inspection on 4 August 2021 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 provider 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.

As part of this inspection we 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:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Blue Cross Dental Care is in Watford, Hertfordshire and is situated in a parade of shops in the town centre. The practice provides NHS and a small amount of private dental care and treatment for adults and children. As well as providing general dentistry it is one of four dental practices in the area to hold an NHS contract to provide minor oral surgery to patients on referral.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking including parking for people with disabilities, is available near the practice.

The dental team includes four dentists, two qualified and two trainee dental nurses, one dental hygienist, and a practice manager. The practice has four treatment rooms one of which is on the ground floor.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

During the inspection we spoke with two dentists, two dental nurses, one dental hygienist, 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 9.00am to 5.30pm.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff provided preventive care and supported patients to ensure better oral health.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had limited systems to help them manage risk to patients and staff.
• There was no system to ensure that regular audits of radiography, antibiotic prescribing and infection control were undertaken at recommended intervals for all clinicians and used to improve the quality of the service.
• The provider did not have effective staff recruitment procedures as not all staff had a recent Disclosing and Barring Service (DBS) check at the point of employment.
• The provider did not keep records to demonstrate that all staff had received training in safeguarding for vulnerable adults and children or infection prevention and control.

We identified regulations the provider was not complying with. They must:

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:

• Take action to ensure all clinicians are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.

• 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 audits of antimicrobial prescribing and record keeping are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

• Implement an effective system for responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.