Sands House Dental Practice

We carried out this announced inspection on 26 September 2019 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 providing well-led care in accordance with the relevant regulations.

Background

Sands House Dental Practice is in High Wycombe and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including space for blue badge holders, is available at the front of the practice.

The dental team includes five dentists, one prosthodontist. two qualified and two trainee dental nurses, one dental hygienist, two receptionists and a practice manager. 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 Sands House Dental Practice is the practice manager.

On the day of inspection, we collected 30 CQC comment cards filled in by patients and obtained the views of 19 other patients.

During the inspection we spoke with two dentists, two dental nurses, two receptionists 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 8.30am – 5.30pm
• Tuesday 8.30am – 5.30pm
• Wednesday 8.30am – 5.30pm
• Thursday 8.30am – 8.00pm
• Friday 8.30am – 5.30pm
• Saturday 8.30am – 12.30pm

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, but improvements were needed to the assessment of COSHH substances.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures.
• 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 had effective leadership and a 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.

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

• Review the current ‘prescribing of antibiotic medicines’ audit tool into account the guidance provided by the Faculty of General Dental Practice.
• Improve the practice's processes for the control identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken.
• Take action to ensure that the use of dental amalgam complies with the European Union Regulation 2017/852 regarding the use and disposal of mercury.
• Develop systems to ensure an effective process is established for the appraisal of all staff.
• Improve the practice protocols regarding auditing patient dental care records, for the prosthodontist, to check that necessary information is recorded.