After a year of inspections, CQC has found that most dental practices are safe.
We started a programme of inspection of all primary care dental providers using our revised methodology, supported by dental specialist advisers, in April 2015. Our approach involves assessing the quality of dental services by asking five key questions on whether the care is safe, effective, caring, responsive and well-led. Based on this, we make a judgement on whether the regulations are being met. We do not give ratings to dental practices.
Since beginning the programme in April 2015, we have published 1,006 inspection reports from our assessment of 967 dental practices (locations). Of these inspections:
- 659 were single location providers
- 308 were locations of a provider with multiple locations.
Our judgements following inspections showed that the vast majority spread across CQC’s four regions in England are meeting the five key questions and providing safe, effective, caring, and responsive care and are well-led.
Where we found poor care, we took regulatory action. Out of the 967 practices assessed, only 93 had regulatory breaches associated with them.
In total, we took enforcement action against eight dental providers for breaching the regulations – in one case, we varied a condition of the provider’s registration and in seven cases we issued a Warning Notice. For the remainder of practices with regulatory breaches, we issued Requirement Notices, which require a provider to make improvements.
The two most common breaches of regulations were of Regulation 12 (safe care and treatment) and Regulation 17 (good governance). Regulation 12 is mapped to the key question ‘are services safe?’ and accounted for 45% of the breaches. Regulation 17 is mapped to the key question ‘are services well-led? and made up 82% of breaches.
The common problems we found were:
- managing complaints and concerns
- completing appropriate risk assessments
- incomplete or out of date dental care records
- supervision, support and staff training
- infection prevention and control
- medicines and equipment to deal with medical emergencies
- incomplete recruitment checks when employing staff.
Improvement
We have re-inspected 35 dental practices in either a focused inspection to follow up on areas of concern where we found regulatory breaches or in a comprehensive inspection.
All the practices re-inspected so far have made the necessary improvements, one of them requiring a second follow-up visit to assure us that it was fully meeting the standards.
To encourage improvement and share good practice, we have now published some examples of notable practice that we found on inspection. We will continue to inspect 10% of all registered dental providers in the coming year.
Further information
- Dental practices in England: There are currently 10,360 dental practices on CQC’s register of locations. Of these:
- 7,402 are single location providers
- 2,958 are locations of providers with more than one location, which includes 1,352 practices that are locations of the biggest 20 corporate brands.
- Regulation breaches: The two most common regulation breaches are Regulation 12: safe care and treatment, which is mapped to the safe key question, and Regulation 17: good governance, mapped to the well-led key question.
- Practice size: Where a provider has only one practice, any breaches found were more likely to be associated with safety than practices of providers with multiple locations. Irrespective of size, most requirement or enforcement actions are associated with well-led key question.
- Dental re-inspection and improvement: All but one practice that CQC re-inspected demonstrated improvements when needed.
Our first year shows that our inspection approach works well. We’re pleased to find that most dental practices are safe, but if we find poor or unsafe care, we will take action.
John Milne, CQC Senior National Dental Adviser