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Archived: Skintek Dental, Laser & Aesthetic Clinic

The provider of this service changed - see new profile

We are carrying out a review of quality at Skintek Dental, Laser & Aesthetic Clinic. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

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.
Inspection areas

Safe

Enforcement action

Updated 28 November 2018

We found that this practice was not providing safe care in accordance with the relevant regulations. The impact of our concerns, in terms of the safety of clinical care, is minor for patients using the service. Once the shortcomings have been put right the likelihood of them occurring in the future is low. We have told the provider to take action (see full details of this action in the Enforcement Actions section at the end of this report). We will be following up on our concerns to ensure they have been put right by the provider.

The practice had a limited awareness and understanding of the importance of monitoring the potential for safety incidents within the practice, to help them improve. The practice systems and processes to provide safe care and treatment required review.

Four staff, including the principal dentist had received training in safeguarding but some staff lacked knowledge and awareness of how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles; the practice did not always complete essential recruitment checks.

The premises had recently undergone refurbishment which was near completion at the time of the inspection. The practice was awaiting final maintenance checks and certificates.

The practice followed national guidance for cleaning and sterilising dental instruments; improvements were made to the storage of dental instruments following the inspection.

Improvements were required to ensure that the practice complied with the Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 with respect to information available to staff, radiation warning signs and the recording of X-rays in patients’ dental care records.

The practice had some arrangements for dealing with medical and other emergencies. We found improvements were required to ensure that logs of the checks of the medicines and equipment were effective.

Effective

No action required

Updated 28 November 2018

We found that this practice was providing effective care in accordance with the relevant regulations.

Improvements were required to ensure that dental care records demonstrated that clinicians assessed needs and delivered care and treatment in line with current legislation, standards and guidance.

The patient population at the practice was very specific. Dental care records demonstrated that patients sought the services provided by the practice for one off treatments.

A dental hygienist had been employed at the practice to provide preventative and supportive care to patients to ensure care was in line with the Delivering Better Oral Health Toolkit.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

The practice supported staff to complete training relevant to their roles but the practice systems to help them monitor this required improvement.

Caring

No action required

Updated 28 November 2018

We found that this practice was providing caring services in accordance with the relevant regulations.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality.

The practice had systems in place to identify patients with specific needs such as those patients who were anxious about visiting the dentist.

Responsive

No action required

Updated 28 November 2018

We found that this practice was providing responsive care in accordance with the relevant regulations.

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. This included providing facilities for disabled patients and ease of access for families with children. The practice was due to complete a disability access audit in order to comply with the requirements of the Equality Act 2010.

The practice took patients views seriously. They valued compliments from patients and told us that any concerns or complaints would be dealt with quickly and constructively.

Well-led

Enforcement action

Updated 28 November 2018

We found that this practice was not providing well-led care in accordance with the relevant regulations. We have told the provider to take action (see full details of this action in the Enforcement Actions section at the end of this report).

The practice had ineffective arrangements to ensure the smooth running of the service. There were limited systems to identify risks to the quality and safety of the care and treatment provided and limited systems for the practice team to discuss potential risks. However, staff reported feeling supported and listened to.

The practice team kept patient dental care records which were, clearly typed although improvements were required to ensure that these were always complete and stored appropriately.

Improvements were required to the systems in place to monitor clinical and non-clinical areas of their work to help them improve and learn.