Archived: Portman Dental Clinic

We undertook a follow up focused inspection of Portman Dental Clinic on 23 December 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was carried out by a CQC inspector.

We undertook a comprehensive inspection of Portman Dental Clinic on 15 July 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

We found the registered provider was not providing well led care and was in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can read our report of that inspection by selecting the 'all reports' link for Portman Dental on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breach we found at our inspection on 15 July 2019

Background

Portman Dental Clinic is in Maidenhead and provides NHS treatment to children and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice on street and in the supermarket car park next to the practice.

The dental team includes three dentists, two periodontists, two endodontists, one prosthodontist, two orthodontists, one paediatric dentist, three dental hygienists, one treatment coordinator/dental nurse, one assistant manager/head nurse, two trainee nurses, and one receptionist.

The practice has four treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Portman Dental Clinic is the practice manager.

During the inspection we spoke with the practice manager and the provider’s operations manager.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday 8:00am to 7:00pm
• Tuesday 8:00am to 5:30pm
• Wednesday 8:00am to 8:00pm
• Thursday 8:00am to 8:00pm
• Friday 8:00am to 5:30pm
• Saturday 8:30am to 5:30pm

Our key findings were:

• Appropriate medicines and life-saving equipment were available.
• The provider had systems to help them manage risk to patients and staff.
• The provider had effective staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• The provider asked staff and patients for feedback about the services they provided.

We carried out this announced inspection on 15/07/19 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 CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five 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:

Are services safe?

We found that this practice was 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

Portman Dental Clinic is in Maidenhead and provides NHS to children and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice on street and in the supermarket car park next to the practice.

The dental team includes three dentists, one paediatric dentist, two periodontists, two endodontists, one prosthodontist, two orthodontists, three dental hygienists, one treatment coordinator and dental nurse, one assistant manager and head nurse, two trainee nurses, and one receptionist. the practice has four treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

At the time of inspection there was no registered manager in post as required as a condition of registration. A registered manager is legally responsible for the delivery of services for which the practice is registered.

On the day of inspection, we collected 46 CQC comment cards filled in by patients and obtained the views of 10 other patients.

During the inspection we spoke with three dentists, two dental nurses, one receptionist and the practice manager, compliance manager and operations manager.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday 8:00am to 7:00pm
• Tuesday 8:00am to 5:30pm
• Wednesday 8:00am to 8:00pm
• Thursday 8:00am to 8:00pm
• Friday 8:00am to 5:30pm
• Saturday 8:30am to 5:30pm

Our key findings were:

• The practice appeared 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 provider had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect.
• Staff provided preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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. Specificity management of COSHH, patient feedback and fire safety, checks for immunity to vaccine preventable infectious diseases, staff recruitment and medicines management.

Full details of the regulation the provider is not meeting are at the end of this report.

There were areas where the provider could make improvements. They should:

• Review the practice’s protocols for or elsewhere the reason for taking X-rays, a report on the findings and the quality of the image in compliance with Ionising Radiation (Medical Exposure) Regulations 2017.
• Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.
• Introduce protocols regarding the prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Review the provider's registration conditions to ensure the regulated activities at Portman Dental Clinic are managed by an individual who is registered as a manager.