N12 Dental Care

We undertook a follow up focused inspection of N12 Dental Care on 29 November 2019. 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 N12 Dental Care on 16 October 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 17 was in breach of regulation 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 N12 Dental Care 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 16 October 2019

Background

N12 Dental Care is in Barnet and provides NHS and private dental treatment to 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, three associate dentists, three dental nurses, one trainee dental nurse, one dental hygienist and two receptionists. The practice has four treatment rooms.

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 N12 Dental Care is the principal dentist.

The practice is open: Mondays to Fridays 8.30am to 5.30pm

Our key findings were:

• The practice had infection control procedures which reflected published guidance and there were arrangements for minimising the risks associated with Legionella.
• The provider had thorough staff recruitment procedures.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had made improvements to its leadership.
• The practice had carried out a Disability Access audit.
• The practice had asked patients for feedback about the services they provided and there were now systems in place for ongoing patient feed to take place.

We carried out this announced inspection on 16 October 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 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 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

N12 Dental Care is in Barnet and provides NHS and private dental treatment to 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, three associate dentists, three dental nurses, one trainee dental nurse, one dental hygienist and two receptionists. The practice has four treatment rooms.

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 N12 Dental Care is the principal dentist.

On the day of inspection, we received feedback from 36 patients including people who completed CQC comment cards and those whom we spoke with during the inspection.

During the inspection we spoke with the principal dentist, one associate dentist, two dental nurses and two receptionists. 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 to 5.30pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The clinical staff provided 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.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• Improvements were required to the practice’s infection prevention and control procedures.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available as per current guidance, although some improvements were required.
• The practice did not have suitable staff recruitment procedures.
• The practice lacked a culture of continuous improvement.
• Risks arising from undertaking of regulated activities had not been suitably identified and mitigated.

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
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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:

• Review the practice protocols regarding audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Review the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.