Patient First Dental Practice

Updated 20 February 2017

The inspection was carried out on 25 November 2016 and was led by a CQC inspector. The inspection team also included a dental specialist advisor.

The methods that were used to collect information at the inspection included interviewing patients and staff, observations and reviewing documents.

During the inspection we spoke with dentist partners and three dental nurses. We reviewed policies, procedures and other records relating to the management of the service.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 20 February 2017

We carried out an unannounced focused inspection on 25 November 2016 to check on the actions taken by the dental provider to make the required improvements which were identified when we carried out a comprehensive inspection on 5 August 2016.

When we carried out a comprehensive inspection on 5 August 2016 we identified areas where improvements were required:

• Risks to the health, safety and welfare of patients and staff were not assessed or managed. Policies and procedures were not routinely followed. The results from risk assessments in relation to fire, health and safety and legionella were not reviewed or acted upon.
• Staff had not undertaken training in relevant to their roles and did not fully understand their responsibilities in relation to areas including radiation protection, safeguarding and infection control.
• Audits and reviews were not carried out to monitor and make improvements to the delivery of the service.

Following this inspection we served the practice with warning notices, in line with our enforcement methodology, in relation to a breach of Regulation 12 Safe care and treatment and Regulation 17 Good governance in line with our enforcement methodology.

Our findings from our unannounced focused inspection on 25 November were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Patient First Dental Practice is a dental practice situated in Grays, Essex.

The practice has four treatment rooms, a combined waiting room and reception area. Decontamination takes place in a dedicated decontamination room (Decontamination is the process by which dirty and contaminated instruments are bought from the treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

The practice is a partnership between two dentists. Four associate dentists, a hygienist, four qualified dental nurses, one trainee dental nurse and one receptionist are employed at the practice.

One of the principal dentists is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons 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 practice offers NHS and private general and cosmetic dental treatments to adults and children. The opening hours of the practice are 9 am to 5 pm Monday to Friday and 9 am to 2 pm on Saturdays. The practice offers late evening appointments up to 9 pm on Thursday evenings. Appointments are available throughout these times, including lunch times.

Treatments using conscious sedation techniques are carried out Saturday each month by pre-arranged appointment. (These are techniques in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation). The conscious sedation techniques were carried out by an external professional, supported by one of the dentists who had undertaken training in this area.

Our key findings were:

• The practice had systems in place for investigating and learning from safety incidents or accidents. Learning from incidents and complaints was used to make improvements where this was required.
• The practice was visibly clean and infection control practices met national guidance. There were systems in place to minimise the risk of legionella and infection control audits were carried out.
• There were a number of systems in place to help keep people safe, including safeguarding vulnerable children and adult procedures.
• There were arrangements in place to assess and manage risks in relation to the premises, equipment and the risk of fire. A range of risk assessments had been carried out and where areas for improvement were identified these were acted upon.
• There were systems in place to ensure that X-ray equipment was tested and maintained safely. Staff undertook relevant training and had access to information to ensure that X-rays were carried out safely and that risks to patients and staff were minimised.
• Staff undertook relevant training in respect of their roles and responsibilities within the practice.
• The practice kept medicines and equipment for use in medical emergencies. These were in line with national guidance and regularly checked so that they were fit for use.
• Effective governance arrangements were in place for the smooth running of the service.
• Patient’s views were sought and used to make improvements to the service where these were identified.