10 Hall Lane Dental Practice Limited

We carried out this announced inspection on 16 December 2021 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 usually ask five key questions. However, due to the ongoing pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These are three of the five questions that form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found this practice was not 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 well-led?

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

Background

10 Hall Lane Dental Practice is in the town of Upminster which comes under the Clinical Commissioning Group of NHS Havering. The practice provides NHS and private dental care and treatment for adults and children.

Ramps are in place to ensure easier access for those people who use wheelchairs and pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available on both the premises and surrounding roads.

The practice has five treatment rooms. The dental team includes two principal dentists, two associate dentists, three dental nurses, three receptionists and one practice manager. At the time of inspection, the practice was actively recruiting for dental hygienists.

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 10 Hall Lane Dental Practice is one of the principal dentists.

During the inspection we spoke with three dentists, four dental nurses, two receptionists and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday to Friday from 8.30am to 5.15pm. During out of hours, patients were advised to contact the NHS 111 service for urgent and emergency care.

Our key findings were:

• The provider had infection control procedures which reflected published guidance.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Not all emergency medicines were available.
• Not all risks to patients and staff were appropriately assessed and mitigated.
• Improvements were needed in relation to fire safety, referrals monitoring and prescription management.
• The provider had staff recruitment procedures which reflected current legislation.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Dental care records we looked at were not completed in line with national guidance.
• The provider dealt with complaints positively and efficiently.
• Not all equipment was serviced as per manufacturer’s guidance to ensure it remained in good working order.
• The dental team was long-standing which meant there was continuity of care and treatment for patients.
• Staff felt involved and supported and worked as a team
• The practice had a suite of policies and procedures; however, they were not effectively used to govern some activities.
• Improvements were needed to the governance arrangements.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
• Take action to ensure dentists are aware of the guidelines issued by the British Endodontic Society for the use of rubber dam for root canal treatment.

Full details of the regulations the provider was not meeting are at the end of this report.