Updated 6 September 2018
We undertook a focused inspection of Mile End Dental Clinic on 17 August 2018. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.
The inspection was led by a CQC inspector who was supported by two specialist dental advisers.
We undertook a comprehensive inspection of Mile End Dental Clinic on 26 April 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care in accordance with the relevant regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Mile End Dental Clinic on our website www.cqc.org.uk.
When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.
As part of this inspection we asked:
• Is it well-led?
Our findings were:
Are services well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
The provider had made improvements in relation to the regulatory breaches we found at our inspection on 26 April 2018.
Background
Mile End Dental Clinic is in Colchester and provides NHS and private treatment to patients of all ages.
There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including one space for blue badge holders, are available at the rear of the practice.
The dental team includes eight dentists, eight dental nurses, two dental hygienists, two receptionists, one implant nurse/manager and one practice manager/dental nurse. The practice has six 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 one dentists, one dental nurse and the implant nurse manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday from 9am to 5.30pm.
Tuesday from 9am to 5.30pm.
Wednesday from 9am to 7pm.
Thursday from 9 am to 6pm.
Friday from 9am to 5.30pm.
Saturday from 9am to 1.30pm.
Our key findings were:
- The practice was giving due regard to the tests, quality checks and operator training for the cone beam computed tomography (CBCT) machine.
- Staff not directly involved in radiography were provided with information sufficient to ensure their continued safety.
- Suitable systems were in place for the recording, investigating and reviewing of accidents or significant events.
- Systems were in place for recording the servicing and maintenance of equipment used for sedation.
- The provider had appointed a training co-ordinator and training administrator to plan training for staff according to their needs.
- Systems were in place to ensure when sedation was provided this was with a single medication and all equipment and medicines were checked again prior to sedation.
- Staff had undergone ILS (Immediate Life Support) training, the dental nurses had undertaken SAAD (Society for the Advancement of Anaesthesia in Dentistry) training. The principal dentist had undergone advanced life support training.
- The practice had implemented information packs for patients undergoing sedation and for patients’ escorts which detailed what to expect before, during and following the procedure.
- The provider had undertaken a Legionella risk assessment by an external provider on 5 June 2018. We noted recommendations and actions identified in the report had been completed.
- The practice was in the process of re-auditing infection control to ensure the next audit was within six months of the previous April 2018 audit.
- Audit procedures had been reviewed with the practice undertaking regular record keeping audits for all clinicians.
- Patient dental records we looked at had detailed recording procedures, and included medication used and information given to the patient.
- Patient dental records detailed that where scans were taken these were justified by dentists.