Archived: Dental Excellence London Limited

Updated 15 October 2015

We carried out an announced, comprehensive inspection on 25 August 2015. The inspection took place over two days with a site visit on 25 August and follow up phone calls on 26 August with people who had used the service. The inspection was led by a CQC inspector. They were accompanied by a dentist specialist advisor.

We reviewed information received from the provider prior to the inspection. We also informed the local Healthwatch that we were inspecting the practice; however we did not receive any information of concern from them.

During our inspection visit, we reviewed policy documents. We spoke with four members of staff, including the dentist. We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. We asked the dental nurse to demonstrate how they carried out decontamination procedures of dental instruments.

Relatively few numbers of patients were being seen at the time of the inspection as this was a new service in the process of building up a client base. However, four people provided feedback about the service. Patients we spoke with and those who responded to a satisfaction survey were positive about the care they received from the practice. They were complimentary about the friendly and patient attitude of the dental staff.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 15 October 2015

We carried out an announced comprehensive inspection on 25 August 2015 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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 providing well-led care in accordance with the relevant regulations.

Background

The Dental Excellence practice is located in the London Borough of Kensington and Chelsea. The premises are located within a larger clinic which provides a range of health and wellbeing services. The dental area consists of one treatment room and a dedicated decontamination room. The dental practice shares a reception and waiting area, as well as patient toilet facilities, with the larger clinic.

The practice provides private dental services and treats both adults and children. The practice offers a range of dental services including routine examinations and treatment, and provides cosmetic dentistry such as veneers.

The staff structure of the practice is comprised of an associate dentist and a practice manager who is also a qualified dental nurse. There is a reception team who work for the larger clinic and book appointments for the dental practice. The practice is open Monday to Saturday from 10.00am to 7.00pm.

This is a new practice which registered with the CQC in November 2014. It has not previously been inspected. The practice manager was applying to become the registered manager at the time of the inspection. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

The inspection took place over one day and was carried out by a CQC inspector and dentist specialist advisor.

Four people provided feedback about the service. Patients we spoke with and those who responded to the practice’s satisfaction survey within the last three months were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.

• Staff understood the process for reporting and recording incidents as well as the importance of identifying shared learning opportunities following the occurrence of incidents or accidents.

• Patients indicated that they felt they were listened to and that they received good care from a helpful and patient practice team.

• The practice had implemented clear procedures for managing comments, concerns or complaints.

• The practice manager had a clear vision for the practice and staff told us they were well supported by the management team.

• The practice did not have effective systems to reduce and minimise the risk and spread of infection

• The practice had not sought appropriate checks for all of the clinical staff or kept a record in relation to the content of verbal references.

We identified regulations that were not being met and the provider must:

• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
• Ensure the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

• Review the training needs for clinical staff in relation to safeguarding adults and children living in vulnerable circumstances.

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

• Improve arrangements for receiving and responding to public health and medical equipment alerts.

• Review the storage of Control of Substances Hazardous to Health (COSHH) products to ensure they are securely stored.

• Develop the use of appropriate and robust governance arrangements and audits to improve the quality and safety of the services.