We carried out an announced comprehensive inspection on 24 July 2015 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?
Our findings were:
Are services safe?
We found that this practice was providing safe care in accordance with the relevant regulations
Are services effective?
We found that this practice was providing effective care in accordance with the relevant regulations
Are services caring?
We found that this practice was providing caring services in accordance with the relevant regulations
Are services responsive?
We found that this practice was providing responsive care in accordance with the relevant regulations
Are services well-led?
We found that this practice was not providing well-led care in accordance with the relevant regulations
Background
CQC inspected the practice on 10 January 2014 and asked the provider to make improvements regarding respecting and involving patients who use the service, assessing and monitoring the quality of the service and record keeping. We checked these areas as part of this comprehensive inspection and found that improvements had been made to respect patients and involve them in their treatment, and measures had been put in place to monitor the quality of the service. We noted that audits had now been put in place however improvements were still required in relation to the quality of the audits. The issues around record keeping had still not been resolved.
Mr Adrian Weiss – Poplar Road is an NHS dental practice located in the London Borough of Merton. The premises consist of one surgery, a waiting room and small reception area.
The practice provides NHS dental services to both children and adults The staff structure consists of one dentist and a dental nurse. Both staff take on the reception and administration duties. The practice is open on Fridays from 9.00am-5.30pm.
We received 17 completed comment cards from patients and spoke with five patients during the inspection. The feedback we received was positive about the service. Patients told us the care and treatment they received was good and generally had positive experiences.
Our key findings were:
- There were effective processes in place to ensure patients were safeguarded from the risks of abuse.
- The practice had processes in place to reduce and minimise the risk of infection
- Clinical staff were up to date with their continuing professional development
- Patients felt involved in making decisions about their treatment and told us they received enough information to make informed decisions
- Patients’ needs were not always suitably assessed and treatment was not planned and delivered in line with best practice guidance such as from the National Institute for Health and Care Excellence
- The practice was not maintaining appropriate dental care records in that dental records were not always complete.
- The practice did not have an automated external defibrillator (AED) and not all emergency medicines were present in line with British National Formulary guidance
- There was a lack of evidence of learning from clinical audits.
- Routine x-rays were not being taken in line with the selection criteria for dental radiography Faculty of General dental practitioners (UK) guidelines
We identified regulations that were not being met and the provider must:
- Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
- Ensure that clinical audits have documented learning points and the resulting improvements can be demonstrated.
You can see full details of the regulations not being met at the end of this report.
There were areas where the provider could make improvements and should:
- Review availability of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
- Ensure all staff are aware of their responsibilities under the Mental Capacity Act (MCA) 2005 as it relates to their role.
- Adopt an individual risk based approach to patient recalls having regard to National Institute for Health and Care Excellence (NICE) guidelines.
- Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.