Say Cheese Dentistry

We carried out this announced inspection on 14 October 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

Say Cheese Dentistry is in Chelmsford, Essex and provides private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available outside the practice.

The dental team includes one dentist, two dental nurses, this included one apprentice dental nurse, and a practice manager who also covered all receptionist duties and who worked remotely. The practice has two treatment rooms, though only one room was used for treatments at the time of our inspection.

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 one dentist and the apprentice dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: from 8.30am to 5pm Monday to Friday.

Our key findings were:

• The practice appeared to be visibly clean. There were areas where the practice required maintenance work and repairs.
• The practice was cluttered with boxes and equipment. Cleaning equipment such as coloured mops and buckets were not colour coded in line with recommended guidance.
• The practice had infection control procedures. Not all infection control procedures were in line with recommended guidance.
• Legionella risk assessments had been undertaken, but there was no evidence that high risk recommended actions had been reviewed.
• Staff knew how to deal with emergencies. Not all appropriate medicines and life-saving equipment were available. The practice took immediate action to rectify this.
• The practice had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• 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.
• Staff felt involved and supported and worked as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice had information governance arrangements.

The provider accepted the clinical and managerial issues that we raised and took immediate action following our inspection to begin to address these. Following the inspection, we were sent evidence to demonstrate that many of the shortfalls have since been addressed.

Where evidence is sent that shows the relevant issues have been acted on, we have stated this in our report, but we cannot say that the practice is compliant for that key question as this would not be an accurate reflection of what was found on the day of our inspection.

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:

• Improve the practice’s systems for environmental cleaning taking into account current national specifications for cleanliness in the NHS.