The Boathouse Dental Surgery

We carried out this announced comprehensive inspection on 11 October 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 practice was visibly clean.
• The practice’s infection control procedures were not effective.
• Staff knew how to deal with medical emergencies.
• The provider did not operate effective systems to help them manage risk to patients and staff.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Staff recruitment procedures were not operated effectively.
• The clinicians provided patients’ care and treatment in line with current guidelines.
• Staff provided preventive care and supported patients to ensure better oral health.
• Staff training was not monitored effectively.
• The provider did not have effective leadership and a culture of continuous improvement.

Background

The Boathouse Surgery is in Goring and provides NHS and private dental care and treatment for adults and children.

The practice is not fully accessible to wheelchair users. Patients are advised of the access barrier when they contact the practice.

The dental team includes 6 dentists, 2 dental nurses, 2 student dental nurses, 3 dental hygienists, and 2 receptionists.

The practice has 3 treatment rooms.

During the inspection we spoke with 2 dentists, 1 dental nurses, 1 student dental nurse, 1 dental hygienist and 2 receptionists.

We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

• Monday 8.30am to 5.30pm
• Tuesday 8.30am to 6.45pm
• Wednesday 9.00am to 7.00pm
• Thursday 9.00am to 5.00pm
• Friday 8.30am to 4.00pm
• Saturday 9.00am to 1.00pm

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

• Ensure care and treatment is provided in a safe way to patients.
  
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  
• Ensure persons employed in the provision of the regulated activity receive the appropriate training necessary to enable them to carry out the duties.
  
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed and specific information is available regarding each person employed.

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

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

• Implement an effective system for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
  
• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
  
• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
  
• Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.

The provider accepted the shortfalls that we raised and took immediate action the day of our inspection to begin to address these.

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.