Poulton Practice Limited

We undertook a follow up focused inspection of Poulton Dental Practice Limited on 16 March 2020. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported remotely by a specialist dental adviser.

We undertook a comprehensive inspection of Poulton Dental Practice Limited on 28 November 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Poulton Dental Practice Limited on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

When one or more of the five questions are not met, we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

Our findings were:

Are services well-led?

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

The provider had made improvements in relation to the regulatory breach we found at our inspection on 28 November 2019.

Background

Poulton Dental Practice in on the outskirts of Poulton le Fylde and provides private treatment for adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes the principal dentist, one dental nurse and one dental hygienist. The practice has one treatment room.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Poulton Dental Practice Limited is the principal dentist.

During the inspection we spoke with the principal dentist and the dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday 9am – 5pm

Friday 9am – 2pm

Our key findings were:

• Dental care records were completed as per the guidance provided by the Faculty of General Dental Practitioners. In particular treatment plans were in place for all patients receiving dental implants. The recordings regarding gum health/periodontal diagnosis and treatment options had improved.

• The provider had reviewed their facilities in line with the requirements of the Equality Act 2010 with regards to the accessible toilet facilities

• The systems and processes had been improved to ensure good governance in accordance with the fundamental standards of care.

We carried out this announced inspection on 28 November 2019 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 provider 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:

Are services safe?

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

Are services effective?

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

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

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

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Poulton Dental Limited is in Poulton le Fylde and provides NHS and private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes the principal dentist, one dental nurse and one dental hygienist. The practice has one treatment room.

The practice is owned by a company and as a condition of registration must have a person registered with the CQC as the registered manager. Registered managers 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 registered manager at Poulton Dental Limited is the principal dentist.

On the day of inspection, we collected seven CQC comment cards filled in by patients.

During the inspection we spoke with the dentist, the dental nurse, and the dental hygienist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday 9am – 5pm

Friday 9am – 2pm.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were not available.
• The provider had limited systems to help them identify and manage risk to patients and staff.
• The provider had insufficient safeguarding processes. Staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider’s staff recruitment policies and procedures did not reflect current legislation.
• The clinical staff did not fully provide patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and 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.
• The provider did not have effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had systems to deal with complaints positively and efficiently.
• The provider had information governance arrangements.

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation the provider is not meeting are at the end of this report.

There were areas where the provider could make improvements. They should:

• Take action to ensure the clinicians take into account the guidance provided by the Faculty of General Dental Practice when completing dental care records. In particular: ensuring treatment plans were in place for all patients receiving dental implants. There was lack of recordings regarding gum health/periodontal diagnosis and treatment options in general dental records.

• Take action to ensure the service takes into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010 with regards to the accessible toilet facilities.