We carried out this announced inspection on 8 December 2021 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 Care Quality Commission, (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 three questions:
• Is it safe?
• Is it effective?
• 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 this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found this practice was providing effective care in accordance with the relevant regulations.
Are services well-led?
We found this practice was not providing well-led care in accordance with the relevant regulations.
Background
6 Ways Dental Practice is in Erdington, Birmingham and provides NHS and private dental care and treatment for adults and children.
The dental team includes seven dentists, six dental nurses, four trainee dental nurses, three dental hygienists, and two receptionists. The practice has seven 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 three dentists and three dental nurses We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday from 8.45am to 5.30pm,
Tuesday from 8.15am to 5.30pm
Wednesday and Thursday from 8.15am to 7.00pm
Friday from 8.45am to 3.00pm
Our key findings were:
- The practice appeared to be visibly clean.
- The provider had infection control procedures but improvements were needed such as audits and cleaning schedules.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider did not have effective systems to help them manage risk to patients and staff.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which reflected current legislation although improvement was needed in the oversight of staff files.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff provided preventive care and supported patients to ensure better oral health.
- Staff felt involved and supported and worked as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- Staff did not follow national guidance when cleaning and decontaminating used dental instruments.
- The provider did not demonstrate effective leadership and a culture of continuous improvement
We identified regulations the provider was not complying with. They must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
Full details of the regulations the provider was 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 of antimicrobial prescribing and record keeping are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
- Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ such as ensuring staff wear the correct personal protective equipment and instruments are storted appropriately.
- Improve 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.
- Take action to ensure the service takes into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.
- Take action to ensure the availability of an interpreter service for patients who do not speak English as their first language.
Implement an effective system for identifying, disposing and replenishing of out-of-date stock.