Updated 12 May 2023
We carried out this announced comprehensive inspection on 20 April 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:
- The dental clinic appeared clean and well-maintained.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to manage risks for patients, staff, equipment and the premises.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice had staff recruitment procedures which reflected current legislation.
- Clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
- Improvements should be made to record keeping in respect of patient care records to ensure guidance from the National Institute for Health and Care Excellence and the College of General Dentistry are followed.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system worked efficiently to respond to patients’ needs.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved, supported and worked as a team.
- Improvements to the system of audits carried out in the practice were needed, particularly in respect of clinical audits.
- Staff and patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The practice had information governance arrangements.
Background
TSA Dental Care is in West Bridgford area of Nottingham 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, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.
The dental team includes 2 dentists, 4 dental nurses including 2 trainee dental nurses, 2 dental therapists, 2 managers and a receptionist. The practice has 4 treatment rooms, all of which are on the ground floor.
During the inspection we spoke with 1 dentist, 3 dental nurses, 1 dental therapist and the 2 managers. We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open: Monday to Thursday from 8am to 6pm and Friday from 8am to 5:30pm
There were areas where the provider could make improvements. They should:
- Take action to ensure the clinicians adopt an individual risk-based approach to patient recalls taking into account the National Institute for Health and Care Excellence guidelines, and ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
- Review the practice protocols regarding audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
- Take action to ensure audits of radiography and infection prevention and control 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.