• Dentist
  • Dentist

Ash Tree House Dental Surgery

6B The Green, Wooburn Green, High Wycombe, Buckinghamshire, HP10 0EE (01628) 532932

Provided and run by:
Basra

Important: The provider of this service changed. See old profile

All Inspections

3 October 2023

During an inspection looking at part of the service

We undertook a follow up focused inspection of Ash Tree House Dental Surgery on 3 October 2023.

This inspection was carried out to review 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 inspection was led by a CQC inspector who was supported remotely by a specialist dental advisor.

We had previously undertaken a comprehensive inspection of Ash Tree House Dental Surgery on 22 March 2023 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 safe and 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 Ash Tree House Dental Surgery on our website www.cqc.org.uk.

When 1 or more of the 5 questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement were required.

As part of this inspection, we asked:

• Is it well-led?

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 22 March 2023

Background

Ash Tree House Dental Surgery is in Wooburn Green and provides NHS and private dental care and treatment for adults and children.

There is step free access to the practice, via a ramp, for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available outside the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 6 dentists, 1 implant specialist, 2 qualified dental nurses, 3 student dental nurses, 3 dental hygienists, 1 practice manager and treatment coordinator, 1 receptionist.

The practice has 4 treatment rooms.

During the inspection we spoke with the provider and the practice manager.

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

The practice is open:

  • Monday 8.30am to 6.00pm
  • Tuesday 8.30am to 5.00pm
  • Wednesday 8.30am to 6.00pm
  • Thursday 8.30am to 6.00pm
  • Friday 8.30am to 3.00pm
  • Saturday 9.00am to 2.00pm (alternate weeks)

22 May 2023

During a routine inspection

We carried out this announced comprehensive inspection on 22 May 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.
  • Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • Staff knew how to deal with medical emergencies, but improvement was needed to ensure emergency medicines and equipment were appropriate.
  • The practice had staff recruitment procedures which reflected current legislation.
  • Clinical staff provided patients’ care and treatment in line with current guidelines.
  • Improvements were needed to infection control procedures to ensure they reflected published 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 practice had systems to manage risks for patients, staff, equipment and the premises but improvements were needed to ensure processes were effective.
  • The appointment system worked efficiently to respond to patients’ needs.
  • 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.
  • The practice had quality assurance processes to encourage learning and continuous improvement, but these were not operated effectively.

Background

Ash Tree House Dental Surgery is in Wooburn Green and provides NHS and private dental care and treatment for adults and children.

There is step free access to the practice, via a ramp, for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available outside the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 6 dentists, 1 implant specialist, 2 qualified dental nurses, 3 student dental nurses, 3 dental hygienists, 1 practice manager and treatment coordinator, 1 receptionist.

The practice has 4 treatment rooms.

During the inspection we spoke with 3 dentists, 2 dental nurses, 1 student dental nurse, 1 dental hygienist, 1 receptionist and the practice manager.

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

The practice is open:

  • Monday 8.30am to 6.00pm
  • Tuesday 8.30am to 5.00pm
  • Wednesday 8.30am to 6.00pm
  • Thursday 8.30am to 6.00pm
  • Friday 8.30am to 3.00pm
  • Saturday 9.00am to 2.00pm (alternate weeks)

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.

There were areas where the provider could make improvements.

They should:

  • Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
  • Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
  • Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
  • Take action to ensure an automated external defibrillator (AED) is available immediately to manage medical emergencies, taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council, and undertake a risk assessment if a decision is made not to have an AED on site.
  • Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.

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

30 August 2013

During an inspection looking at part of the service

When we visited the service on 21 June 2013, we had concerns about how this standard was being managed. This was because the full range of required recruitment checks had not been carried out. This placed patients at risk of harm. We set a compliance action for the provider to improve practice.

We returned to the service on 30 August 2013 to check whether improvements had been made. We found the provider had taken action to ensure shortfalls had been addressed in meeting the regulations. This included obtaining up to date Disclosure and Barring Service checks for staff and ensuring any verbal references were now supported in writing.

We saw the provider had produced a checklist for any future recruitment. This would help ensure appropriate checks were undertaken before staff began work at the surgery.

We were satisfied the provider had taken sufficient action to become compliant with this standard.

21 June 2013

During a routine inspection

We spoke with four people who had received treatment on the day of our visit. Each person was satisfied with the service they had received. One person told us 'I'm quite happy with everything they do.' No one had any concerns about the practice. People told us staff were friendly and helpful. They said they were able to arrange appointments easily. People said they were given options for their treatment and costs were explained to them. One person told us 'Although I'm an NHS patient, they always tell me what the private options are as well so I can make a choice.'

We found there were effective systems in place to reduce the risk and spread of infection. Staff had received training in infection control practice. There were infection control policies and procedures to provide staff with guidance on good practice. Thorough decontamination processes were used to ensure instruments were cleaned hygienically after use.

We found weaknesses in the recruitment and selection processes used at the surgery. The full range of required checks had not been undertaken for new staff. This placed people at risk of harm.