Updated 5 January 2023
We carried out this announced comprehensive inspection on 28 November 2022 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 adviser.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five 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 was visibly clean and well-maintained.
- The practice had infection control procedures which reflected published guidance. However, improvements should be made in two treatment rooms to ensure the flooring is appropriately sealed and dental chairs are free from tears.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to help them manage risk to patients and staff.
- 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.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The dental clinic had information governance arrangements.
Background
The provider has a large portfolio of practices and this report is about Bupa Dental Care Exeter.
Bupa Dental Care Exeter is in Exeter and provides NHS treatment for adults and children. A small amount of private dental care is also available.
There is step access to the practice and all treatment rooms require access via stairs. Alterations to make the practice accessible for people with limited mobility or wheelchair users are not feasible due to the building design and location. People with mobility restrictions are signposted to other local practices within the Bupa group. Car parking spaces are available at nearby city centre car parks.
The dental team includes two dentists, one dental hygienist (who works one day per week), one lead dental nurse, one dental nurse, two student dental nurses, one practice coordinator, two receptionists and a practice manager. There are current vacancies for two full-time and one part-time dentists. These vacant posts are advertised. The number of clinician vacancies is currently impacting upon the ability to meet NHS appointment contract expectations. The practice has five treatment rooms, of which four are in use.
During the inspection we spoke with one dentist, one lead dental nurse, one agency dental nurse, two student nurses, two receptionists, the practice manager and two practice managers from other local practices supporting the inspection. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open: Monday to Friday 8.30am – 5.00pm.
The practice had taken steps to improve environmental sustainability. For example, there are bike racks outside the practice for patients to use to secure their bicycles.
There were areas where the provider could make improvements. They should:
- Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular, dental instruments were sterilised with bands on, flooring in two surgeries was not completely sealed and there was a tear in one dental chair.
- Improve the practice's processes for the control of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.