Updated 16 January 2024
We carried out this unannounced comprehensive inspection on 1 December 2023 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:
- Appropriate medicines and life-saving equipment were available.
- 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, and 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.
- 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.
- The dental clinic appeared clean and well-maintained, however, the practice infection control procedures did not fully reflect published guidance.
- Improvements were needed to the systems of managing risks for patients and staff. This included risks associated with premises, use of equipment, and the delivery of care using conscious sedation. All staff involved in the delivery of treatment under conscious sedation had not completed Immediate Life Support training (or basic life support training with airway management).
- There were ineffective processes in place to identify and report abuse of vulnerable adults and children.
- The practice did not have suitable recruitment procedures to comply with current legislation.
- There was ineffective leadership, and systems in place to support continuous improvement were not effective.
Background
Court Drive Dental Practice is in Uxbridge, in the London Borough of Hillingdon, and provides NHS and private 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 are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.
The dental team includes the principal dentist, 5 associate dentists, 1 dentist specialising in endodontics, periodontics, prosthodontics and restorative dentistry, 1 oral and maxillo-facial surgeon, 3 dental nurses, 1 dental hygienist and 2 receptionists. They are supported by a consultant practice manager. The practice has 4 treatment rooms.
During the inspection we spoke with the consultant practice manager, 1 associate dentist, 1 dental nurse and 1 receptionist. We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open:
Monday to Thursday from 8.30am to 5pm
Friday from 8.30am to 4pm
Saturday from 8.30am to 2pm.
We identified regulations the provider was not complying with. They must:
- Ensure care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- Ensure persons employed in the provision of the regulated activities receive appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.
- Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
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 record keeping and antimicrobial prescribing are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.