Updated 21 August 2019
We undertook a focused follow up inspection of Mr Gehad Philobbos on 12 June 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 by a specialist dental adviser.
We previously undertook a comprehensive inspection of Mr Gehad Philobbos on 29 August 2018 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 safe, effective or well led care and was in breach of regulations 9, 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We carried out a focused inspection on 19 December 2018 to check whether the provider had made the required improvements. The provider had made some improvements, these were insufficient to put right the shortfalls we found at our inspection on 29 August 2018. You can read our report of the previous inspections by selecting the 'all reports' link for Mr Gehad Philobbos on our website www.cqc.org.uk.
As part of this inspection we asked:
• Is it safe?
• Is it effective?
• 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 areas where improvement was required.
Our findings were:
Are services safe?
We found this practice was not providing safe care in accordance with the relevant regulations.
The provider had made insufficient improvements to put right the shortfalls and had not responded effectively to the regulatory breaches we found at our inspection on 29 August 2018 and 19 December 2018.
Are services effective?
We found that this practice was not providing effective care in accordance with the relevant regulations.
The provider had made some improvements in relation to the regulatory breach. These were insufficient to put right the shortfalls we found at our inspections on 29 August 2018 and 19 December 2018.
Are services well-led?
We found that this practice was not providing well-led care in accordance with the relevant regulations.
The provider had made some improvements in relation to the regulatory breach. These were insufficient to put right the shortfalls we found at our inspections on 29 August 2018 and 19 December 2018.
Background
Mr Gehad Philobbos is in Oldham and provides NHS treatment to adults and children.
There are two steps leading to the entrance of the premises. On street parking is available near the practice.
The dental team includes one dentist, a trainee dental nurse and a practice manager who also carry out reception duties. The practice has one treatment room.
The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
During the inspection we spoke with the dentist, the practice manager and the trainee dental nurse. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Tuesdays and Thursdays 9.30am to 12.45pm and 2pm to 5.30pm
Our key findings were:
- Staff knew how to respond to a medical emergency and completed training in emergency resuscitation and basic life support. The medical emergency kit had been reviewed and appropriate items were available.
- Systems to identify and respond to risk were not effective. For example, in relation to decontamination processes and radiography.
- The provider did not demonstrate effective leadership of the practice. They were unaware of the ongoing issues highlighted during the inspection.
- The improvements made were insufficient to demonstrate that care and treatment was assessed and delivered in line with current legislation.
- Discussions with the provider showed they lacked understanding of how to analyse the results of audits and use these to make improvements in line with General Dental Council standards.
We identified regulations the provider was not meeting. They must:
- Ensure the care and treatment of patients is appropriate, meets their needs and reflects their preferences.
- 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.
Full details of the regulations the provider is not meeting are at the end of this report.
The provider has cancelled their registration as a provider of regulated activities. A new provider has now taken over the practice and is responsible for the leadership, governance and provision of patient care.