Archived: Mydentist - Duke Street - South Molton

The purpose of this desktop review carried out on 5 January 2015 was to follow up the remaining compliance actions. We did not speak to patients using the service. This was because the areas we needed to check related to management systems with the purpose of reducing potential risks to patients. We asked Integrated Dental Holdings (IDH), which owns Murgelas Practice Management Ltd. to provide documents to show how the remaining actions had been addressed.

The actions taken since the ownership changed in May 2014 demonstrated that the management of the practice had consistently improved. The provider acted robustly to make improvements in a timely way. The evidence provided shows that the provider had sustained these improvements. The quality systems used by the provider enabled them to identify gaps and emerging issues so action plans were put in place and monitored. The provider had achieved compliance in all areas we were previously concerned about.

The purpose of this inspection was to follow up the Warning Notice served in March 2014, which focussed on the quality monitoring systems. We wanted to see if patients received a safe, effective and well led service in relation to specific areas of concern we had identified. We did not speak to patients using the service. This was because the areas we needed to check related to management systems with the purpose of reducing potential risks to patients. We gave short notice of the inspection because we needed a representative of Integrated Dental Holdings (IDH) to be present as the practice currently does not have a registered manager.

We saw significant improvements in quality monitoring systems, working practices and the overall environment. We saw robust infection control, recruitment and quality systems that were effective and ensured patient safety. Staff were being supported and had told us they had received a comprehensive induction to the new company provider and training in subjects including infection control practice. Overall, the actions taken since the ownership change demonstrated that the practice was well led. We were satisfied the organisation had acted in both a robust and timely way and concluded the provider was now compliant with the Warning Notice.

The timescale for completion of actions relating to concerns in May 2014 has yet to be reached. Therefore, we will carry out another follow up inspection once the action plan has been met and will report on our findings.

We were so concerned at how the provider managed carried out quality assurance processes including managing and learning from complaints we issued a Warning Notice to the provider. Following the inspection the provider submitted an action plan of how they intended to meet the compliance actions and Warning Notice. This visit was carried out after the provider declared they were compliant with the regulations. A Specialist Advisor came with us to help evaluate the quality of the practice.

During this inspection we wanted to assess whether patients now received treatment from a safe, effective, caring, responsive and well led service. We visited the premises, looked at the environment, reviewed five patient records, spoke with patients visiting the practice and reviewed records relating to the management of the service. We spoke with the practice manager, dental nurses, one dentist and administration staff. The practice had been without a registered manager since July 2013.

We found there remained significant risks to patients who used the service. We saw that practical improvements had been made including repairs to the electrical system and hot water for hand washing in the toilet. The provider had implemented some audit systems to monitor the quality of the service. However, we identified through investigation of complaints made to the service that patients were at considerable risk from some of the practices and the management at Duke Street Dental Practice.

Following the inspection visit on 13 May 2014 the provider company Murgelas Practice Management Ltd has been acquired by another major provider who has taken responsibility to improve the service. They have provided us with a detailed action plan as to how they intend to implement these changes. So we have taken this into consideration in regard to our next steps to ensure essential standards will be met.

Patients experienced care, treatment and support that met their needs and protected their rights. Patients we spoke with told us about their experiences using the dental surgery. Some had been coming to the surgery many years and they liked the friendly approach the staff had. One patient told us, “They are lovely, nothing is any trouble.” Another said “I have no concerns about the treatment they provide.”

Patients told us they felt the surgery was kept clean and hygienic. One patient said, “Hygiene seems good.” They also told us they had observed, “Staff wear gloves and glasses when I have treatment.”

We found there were gaps in how the service provided information to patients and prospective patients about the services available to them including the fees they may incur. There were minor risks to the management of infection control as staff had not followed government guidelines and disposed of single use dental equipment after use. Safe storage and management of medicines were not carried out in accordance with current good practice. There was insufficient information to show that safe and robust recruitment was carried out to ensure that appropriate skilled and experienced staff were employed. We had moderate concerns about how the service carried out quality assurance processes including managing and learning from complaints. We found improvements were needed in the overall standard of record keeping.