The Care Quality Commission
  • Dentist
  • Dentist

Ashfield House (High Bentham)

66 Main Street, High Bentham, Lancaster, Lancashire, LA2 7HZ (015242) 64813

Provided and run by:
Mr Mark White

All Inspections

29 June 2020

During an inspection looking at part of the service

We undertook a follow up desk-based inspection of Ashfield House (High Bentham) Dental Practice on the 29 June 2020. 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 undertaken by a CQC inspector who had remote access to a specialist dental adviser.

We undertook a comprehensive inspection of on 5 March 2020 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 safe and well led care and was in breach of regulations 12 and 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 Ashfield House (High Bentham) Dental Practice on our website .

As part of this inspection we asked:

  • Is it safe?
  • 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.

This desk-based inspection was undertaken during the Covid 19 pandemic. Due to the demands and constraints in place because of Covid 19 we reviewed the action plan and asked the provider to confirm compliance after a reasonable interval, focusing on the area where improvement was required.

Our findings were:

Are services safe?

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

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 05 March 2020.

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 breaches we found at our inspection on 05 March 2020.

Background

Ashfield House (High Bentham) Dental Practice is in High Bentham on the Lancashire and North Yorkshire border and provides private dental care and treatment for adults and children.

There is level access at the rear of the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes one dentist, one dental nurse and one receptionist. The practice has one treatment room.

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.

The practice is open:

Monday to Wednesday: 9.00 – 5pm

Thursday: 2.00 – 9pm

Friday: Closed  

Our key findings were :

  • The provider had implemented infection control procedures which fully reflected published guidance in particular: the reprocessing of un-bagged dental instruments.
  • The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. Safeguarding training for staff could be demonstrated.
  • The provider had improved staff recruitment procedures reflected current legislation for example; there were records of staff’s immunisation status.
  • The provider had established an effective leadership and a culture of continuous improvement.
  • Clinical leadership and oversight of arrangements for managing risk were now effective, for example; the health and safety and the general risk assessments had been reviewed.
  • Improved the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment, in particular the collimator had been fitted to the X-ray machine.

05/03/2020

During a routine inspection

We carried out this announced inspection on 05 March 2020 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.

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 this practice was not 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 caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive 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

Ashfield House dental practice is in High Bentham on the Lancashire and North Yorkshire border and provides private dental care and treatment for adults and children.

There is level access at the rear of the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes one dentist, one dental nurse and one receptionist. The practice has one treatment room.

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.

On the day of inspection, we collected 14 CQC comment cards filled in by patients

During the inspection we spoke with the principal dentist, the dental nurse and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Wednesday: 9am – 5pm

Thursday: 2pm – 9pm

Friday: Closed

Our key findings were:

  • The practice appeared to be visibly clean and well-maintained.
  • The provider had infection control procedures which did not fully reflect published guidance, in particular in relation to the reprocessing of unwrapped dental instruments.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. The provider could not demonstate that safeguarding training for all staff had been completed.
  • The provider had not reviewed the radiation protection arrangements to ensure the practice had fulfilled the legal obligations and staff were following the recognised guidance.
  • The provider’s staff recruitment procedures did not reflect current legislation. There were no records of staff immunisation status or references being sought for two members of staff.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and 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.
  • The provider did not have effective leadership or a culture of continuous improvement.
  • Staff felt involved and supported and worked as a team.
  • The provider asked staff and patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • Governance arrangements were not effective. The provider had no means in place to ensure policies, procedures and risk assessments were regularly reviewed.

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

  • Ensure care and treatment must be provided in a safe way for service users.
  • Establish effective systems and procedures to ensure good governance in accordance with the fundamental standards of care.

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


14 March 2013

During a routine inspection

We talked with people who were receiving treatment during our visit. They confirmed they were consulted about the options available to them and given information to help them make decisions about their treatments. People also said that they were happy with the care and treatment they received. Comments made included, 'I travel a long way to use this dentist. I think that shows how much I trust this dentist and they have made me feel at ease.' And 'I am very nervous of any dental work done, but Mark [the dentist] has taken time with me and made me feel at ease, safe and reassured.'

We reviewed the treatment records and they showed that treatment was appropriately planned and recorded.

We confirmed that procedures were in place to ensure that equipment was cleaned, decontaminated and sterilised. We also saw that suitable arrangements were in place to provide emergency first aid and resuscitation if needed.

Information on how to make a complaint was available to people who used the service. People confirmed that they felt able to raise any concerns they had directly with the dentist and staff if they needed.