Marylebone House Dental Practice

We carried out this announced inspection on 05 August 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 providing well-led care in accordance with the relevant regulations.

Background

Marylebone House Dental Practice is in Westminster and provides NHS and private 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, including one for blue badge holders.

The dental team includes six dentists, three dental nurses, two trainee dental nurses (who also work on the reception desk), a head nurse, a receptionist and the practice manager. The practice has three 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 Marylebone House Dental Practice is the practice manager.

On the day of inspection, we collected two CQC comment cards filled in by patients and spoke with three other patients.

During the inspection we spoke with two dentists, two dental nurses, reception staff and the practice manager. We also spoke with the provider’s compliance manager who was present on the day of the inspection. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 8.00am to 7.00pm

Saturday 9.00am - 1.00pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which generally reflected published guidance. However some improvements were required in regards to cleaning used dental instruments.
• Staff knew how to deal with emergencies. Most medicines and life-saving equipment were available. However there were some medicines missing from the kit.
• The provider had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures.
• 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.
• Staff provided patients with preventive oral care and supported them to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• 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.
• The provider had suitable information governance arrangements.

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

• Review the practice’s infection control procedures and protocols 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 specifically in regard to cleaning and pouching dental instruments.
• Review the availability of medicines in the practice to manage medical emergencies taking into account the guidelines issued by the British National Formulary and the General Dental Council.