Updated 28 November 2018
We carried out this unannounced inspection on 18 October 2018 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 not 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 not providing well-led care in accordance with the relevant regulations.
Background
Skintek Dental, Laser and Aesthetic Clinic is in Crawley, West Sussex and provides private treatment to adults.
There is step free access for people who use wheelchairs and those with pushchairs. Car parking spaces for blue badge holders are available near the practice which is within a short walk of car parks.
The dental team includes the principal dentist, one associate dentist, one dental hygienist one dental nurse and two part-time receptionists. The practice has three treatment rooms.
The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
During the inspection we spoke with two dentists, one dental hygienist, one dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
- Tuesday, Thursday and Friday 9.30am to 7pm
- Wednesday 9.30am to 6pm
- Saturday 9am to 5pm
Our key findings were:
- The clinical staff provided patients’ care and treatment based on patients’ needs.
- Staff took care to protect patients’ privacy and personal information. Improvements were required to the storage of patients’ dental care records.
- The practice was providing preventive care and supporting patients to ensure better oral health.
- The practice premises were clean and had recently undergone a total refurbishment.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. All life-saving equipment and most medicines were available as described in recognised guidance.
- The practice had limited systems to help them manage risk. Governance arrangements were poor and ineffective.
- The practice had limited safeguarding processes and not all staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice staff recruitment procedures required improving.
- The appointment system met patients’ needs.
- The practice lacked effective leadership and there were limited systems in place to encourage continuous improvement.
- The practice asked staff and patients for feedback about the services they provided.
- The practice had systems to deal with patient complaints positively and effectively.
- Improvements were required to the information governance arrangements.
We identified regulations the provider was not complying with. They must:
- Ensure patients are protected from abuse and improper treatment
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
- Ensure specified information is available regarding each person employed.
Full details of the regulation/s the provider was/is not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Review the practice's protocols and procedures for the use of X-ray equipment in compliance with the Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. Ensuring that local rules reflect the equipment in the practice, radiation warning signs are in place and recording in patient’s dental care records the reason for taking X-rays and a report on the findings and quality of the image.
- Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010. Ensuring that a disability access audit is complete.