Updated 9 March 2023
We carried out this announced comprehensive inspection on 10 February 2023 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 practice 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 advisor.
To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:
- The dental clinic appeared clean and well-maintained.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available. Improvements were required to ensure glucagon was stored appropriately and all equipment were available in line with guidance.
- The practice had systems to manage risks for patients, staff, equipment and the premises.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice had staff recruitment procedures which reflected current legislation.
- Clinical staff provided patients’ care and treatment in line with current guidelines. Improvements were required to ensure dental care records reflected guidance.
- Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system worked efficiently to respond to patients’ needs.
- The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved, supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The practice had information governance arrangements.
Background
Marsh House Orthodontics is in Figges Marsh in the London borough of Merton and provides private orthodontic dental care and treatment for adults and children.
The practice is set out over 3 floors. There is step free access to the practice for people who use wheelchairs and those with pushchairs, however all the surgeries are on the upper levels and not accessible. The provider has two other orthodontic practices where they can refer patients to for treatment. The practice has a car park for staff and patients.
The dental team includes a principal dentist, 1 associate dentist, 3 visiting specialists, 1 dental hygienist, 1 dental therapist, 4 dental nurses, 3 receptionists, 1 general manager (who was also one of the owners), 1 deputy practice manager and a practice manager (who is also a qualified dental nurse). The practice has 6 treatment rooms.
During the inspection we spoke with 1 of the visiting specialists, 1 dental nurse, the 3 receptionists, the practice manager and 1 of the practice owners. We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open:
Monday 8am to 6pm.
Tuesday 8am to 5pm.
Wednesday and Thursday 9am to 7.30pm.
Friday 8am to 4pm.
There were areas where the provider could make improvements. They should:
- Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
- Take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the British National Formulary and the General Dental Council.
- Take action to ensure the availability of medicines in the practice to manage medical emergencies taking into account the guidelines issued by the British National Formulary and the General Dental Council. In particular ensuring that glucagon is stored in line with guidance.
- Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.