Updated 25 February 2022
We carried out this announced focused inspection on 2 February 2022 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 usually ask five key questions, however due to the ongoing pandemic and to reduce time spent on site, only the following three questions were asked:
• Is it safe?
• Is it effective?
• Is it well-led?
These questions form the framework for the areas we look at during the inspection.
Background
Cripps Dental Centre is in Nottingham and provides NHS and private dental care and treatment for adults and children.
The practice is on the first floor of a purpose-built Health centre. Access is via stairs or a passenger lift to the first floor. This makes access into the practice for people who use wheelchairs and those with pushchairs easy. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice.
The dental team includes five dentists, two dental hygienists, nine dental nurses, including three apprentice dental nurses, four reception staff and a practice manager. The practice has eight treatment rooms, all of which are on the first floor.
During the inspection we spoke with dentists, dental nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday from 8am to 7:30pm, Tuesday to Thursday from 8am to 5:30pm and Friday from 8am to 4:30pm.
Our findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. Some items were missing during the inspection, however, replacements were ordered on the day.
- The provider had systems to help them manage risk to patients and staff. We noted hot water was not achieving the recommended temperature to reduce the risk of Legionella, and this was being investigated.
- 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.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- National guidance was not being followed in respect of antimicrobial prescribing audits.
- The provider had effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- The provider had information governance arrangements.
There were areas where the provider could make improvements. They should:
- Take action to ensure audits of antimicrobial prescribing are undertaken at regular intervals as identified in national guidance.
- Take action to implement any recommendations in the practice's Legionella risk assessment, 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.’ In particular take action to investigate the hot water temperatures to ensure the risk of Legionella is reduced.
- Implement an effective system of checks of medical emergency equipment and medicines taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.