Updated 28 May 2021
We undertook a follow up focused inspection of The Cottage Dental & Implant Clinic Limited on Tuesday 20 April 2021. 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. We also reviewed regulations 19 fit and proper persons employed and 18 staffing.
The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
We undertook a comprehensive inspection of The Cottage Dental & Implant Clinic Limited on 26 November 2019 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 safe or well led care and was in breach of regulations; 12 Safe care and treatment and 17 Good governance 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 The Cottage Dental & Implant Clinic Limited on our website www.cqc.org.uk.
As part of this inspection we asked:
• Is it safe?
• Is it well-led?
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.
Our findings were:
Are services safe?
We found this practice was providing safe care in accordance with the relevant regulations.
The provider had made improvements in relation to the regulatory breach we found at our inspection on 26 November 2019.
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 breach we found at our inspection on 26 November 2019.
Background
The Cottage Dental & Implant Clinic Limited is in Wootton Bassett, near Swindon and provides mainly private treatment for adults and children with a small NHS contract.
A temporary ramp can be used for patients requiring assistance into the practice as there is not level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for patients with disabilities, are available near the practice.
The dental team includes one dentist, one trainee dental nurse, a consultant manager (for governance implementation only) and two receptionists. The practice has two treatment rooms.
The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at The Cottage Dental & Implant Clinic Limited is the principal dentist.
During the inspection we spoke with the dentist, the trainee dental nurse, the consultant manager and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
- Monday to Thursday 8:30am-5:30pm
- Friday 8:30am-1:30pm
Our key findings were:
- The systems in place to manage medical emergencies had improved. Monitoring of the equipment was carried out at appropriate intervals. All equipment and medicines were held at the practice in accordance with guidelines.
- Medicines were monitored to ensure they were safe to use and within their useby date.
- Infection control equipment was now maintained at appropriate intervals, in accordance with guidelines and manufacturers instructions.
- Actions had been addressed following a legionella risk assessment and regular monitoring was in place to reduce the risks associated with legionella.
- There was a process in place to monitor and report on incidents.
- The provider informed us conscious sedation had not been carried out since our last inspection and would be started again when there was sufficiently trained staff.
- Infection control audits had not been completed on a six monthly basis but there was a plan in place to ensure this was consistently completed in the future.
- A safer sharps risk assessment had been completed in accordance with what procedures were in place at the practice.
- The provider had ensured portable appliance testing and an electrical installation safety check had been carried out.
- Patient feedback was sourced and analysed to ensure the provider could constantly improve its service.
- There was an induction process in place and this was followed when staff were recruited.
- There was a system in place to ensure staff were recruited safely. The provider needed to ensure if there was missing information when staff were recruited then a risk assessment was carried out.
- There was a system in place to ensure staff were suitably trained and supported to carry out their role effectively.
There were areas where the provider could make improvements. They should:
- Implement an effective recruitment procedure to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.
- Take action to ensure that all clinical staff have a risk assessment in place until there is evidence of adequate immunity for vaccine preventable infectious diseases.
- 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.