Updated 3 May 2024
We carried out this announced comprehensive on 26 March 2024 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.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with medical emergencies. The majority of appropriate medicines and life-saving equipment were available.
- The practice had some systems to manage risks for patients, staff, equipment and the premises.
- Systems to help staff manage legionella, fire, emergency lighting and clinical waste risk were not effective.
- Evidence of up-to-date staff training was not available.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice had staff recruitment procedures which reflected current legislation. However, staff recruitment records could not be located.
- Clinical staff provided patients’ care and treatment in line with current guidelines.
- 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 appointment system worked efficiently to respond to patients’ needs.
- The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
- There was ineffective leadership and a culture of continuous improvement. Improvement was needed to ensure effective leadership, oversight and management.
- Staff felt involved, supported and worked as a team.
- Patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The practice had information governance arrangements.
Background
Aspire Dental Care Limited is part of a corporate group Aspire Dental Health Ltd, a dental group provider.
Aspire Dental Care Limited is in Dagenham and provides NHS dental care and treatment for adults and children.
There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.
The dental team includes 2 dentists, 1 qualified dental nurse, 2 trainee dental nurses, 1 practice manager and 2 receptionists. The practice has 2 treatment rooms.
During the inspection we spoke with 1 dental nurse, 1 receptionist, the group’s clinical director and the registered manager who is also the group’s business manager. We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open:
Monday to Friday from 8am to 5:30pm
Saturday from 9am to 2:30pm
We identified regulations the provider was/is not complying with. They must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- Ensure the practice's risk management systems is effective for monitoring and mitigating the various risks arising from the carrying on of the regulated activities. In particular, take action to mitigate risks to Legionella, emergency lighting and fire.
- Take action to ensure that all the staff have received up to date training.
- Improve the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
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:
- Take action to ensure audits have documented learning points and the resulting improvements can be demonstrated.
- Implement an effective system for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
- Implement an effective system of checks of medical emergency equipment and medicines taking into account the guidelines issued by the Resuscitation Council (UK).