Updated 16 July 2021
We carried out this announced focussed inspection 24 June 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 asked the following three questions:
• Is it safe?
• Is it effective?
• 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 well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
Background
Ashfield House Dental Practice is in a rural location to the west of Wem in Shropshire and provides 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, including dedicated parking for people with disabilities, are available at the practice.
The dental team includes one dentist, and one dental nurse who is also the receptionist and practice manager. The practice has one treatment room, which is located on the ground floor.
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 Ashfield House Dental Practice is the principal dentist.
During the inspection we spoke with the 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 Friday 8am to 5pm
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 available.
- The provider had implemented standard operating procedures in line with national guidance on COVID-19. At the time of this inspection FFP3 masks were not available for aerosol generating procedures.
- The provider had systems to help them manage risk to patients and staff.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- Improvements could be made to the monitoring of hot and cold-water temperatures in line with the Legionella risk assessment.
- The provider had staff recruitment procedures which reflected current legislation.
- 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.
- Information held at the practice relating to the Control of Substances Hazardous to Health Regulations 2002 could be improved.
- Staff provided preventive care and supported patients to ensure better oral health.
- Improvements could be made to the record keeping at the practice.
- Staff felt involved and supported and worked as a team.
There were areas where the provider could make improvements. They should:
- Take action to ensure that all clinical staff have adequate FFP3 masks when completing aerosol generating procedures to protect themselves and patients from the risk of COVID-19 being spread within the practice.
- Improve the practice's processes for the control and storage 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.
- Take action to ensure the clinicians take into account the guidance provided by the Faculty of General Dental Practice when completing dental care records and auditing antimicrobial prescribing.
- Take action to implement any recommendations in the practice's Legionella risk assessment, 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 ensure that hot water taps produce water at a temperature above 55 degrees centigrade and cold-water taps produce water at a temperature below 20 degrees centigrade. Weekly records should be kept to demonstrate this.