Updated 11 January 2021
We undertook a follow up desk-based review of North Street Dental Practice on 23 December 2020. This review 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 review was led by a CQC inspector.
We undertook a comprehensive inspection of North Street Dental Practice on 10 February 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 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 North Street Dental Practice on our website www.cqc.org.uk.
As part of this review 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 (requirement notice only). We then review 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 10 February 2020.
Background
North Street Dental Practice is in Bourne, a town in the South Kesteven district of Lincolnshire. It provides mostly private dental care and treatment for adults. There is a small contract with NHS England for the provision of NHS dental care for children.
There is level access to the practice for people who use wheelchairs and those with pushchairs through an entrance at the rear of the premises. There are no car parking facilities on site, but there is on street car parking with time restriction at the front of the premises.
The dental team includes two dentists, two dental nurses, one dental hygienist and one receptionist. During the Covid-19 pandemic, one of the dentists and the hygienist were not working.
The practice has three treatment rooms; one on ground floor level.
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 review we spoke with the principal dentist and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is usually open: Monday 9am to 5pm, Tuesday 9.15am to 5pm, Wednesday 9.15am to 2pm, Thursday 8am to 5pm, Friday 9am to 1pm and on six Saturdays during the year from 9am to 1pm.
During the Covid-19 pandemic, opening hours had changed to Monday 9am to 4pm, Tuesday 9am to 4pm, Wednesday 9am to 2pm, Thursday 9am to 4pm and Friday 9am to 2pm. They were not currently working on Saturdays but offered a late evening once a month from 1pm to 8pm.
Our key findings were:
- The systems for monitoring and improving quality had improved, for example, audit activity in relation to radiographs and dental record keeping.
- The processes for monitoring stock control had strengthened, with named members of staff assigned the task of managing this. We reviewed a new policy that had been implemented.
- X-ray equipment had received three yearly routine quality assurance measurements.
- There were changes and improvements to patients’ dental care record keeping with new templates that had been implemented for use by clinicians. The principal dentist had also updated their training in this area.
- Security of NHS prescription pads had improved so that it would be identified if an individual prescription was taken inappropriately.
- The provider assured us that they had all equipment needed to manage medical emergencies for example, the appropriate sizes of clear face masks.
- There was a system for receiving and responding to patient safety alerts issued by the Medicines and Healthcare products Regulatory Agency.
- The provider had taken action to incorporate guidance issued by the Faculty of General Dental Practice.
- Staff had undertaken additional training to improve their awareness of the Mental Capacity Act 2005 and Gillick competence.