Updated 23 March 2022
We carried out this announced focused inspection on 9 March 2022 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 practice 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 COVID-19 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 questions form the framework for the areas we look at during the inspection.
Our findings were:
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice had staff recruitment procedures which reflected current legislation.
- The dental clinic appeared to be visibly clean and well-maintained.
- The practice had systems to help them manage risk to patients and staff although these could be strengthened. We found shortfalls in appropriately assessing and mitigating risks in relation to patient safety alert management and incident reporting.
- The practice had infection control procedures which mostly reflected published guidance.
- Staff knew how to deal with medical emergencies. Appropriate emergency medicines and most life-saving equipment were available. Missing equipment including, a paediatric self-inflating bag, masks and an airway were ordered immediately after the inspection.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- There was effective leadership and a culture of continuous improvement. However, we found antimicrobial prescribing audit was not completed and radiography audit was not completed at the required frequency.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- The dental clinic had information governance arrangements.
Background
The provider has one practice and this report is about Appledore Dental Care Milton Keynes.
Appledore Dental Care is in Milton Keynes 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 near the practice. The practice has made some adjustments to support patients with additional needs.
The dental team includes five dentists, one trainee dental nurse, one dental therapist and two receptionists. The practice has three treatment rooms.
During the inspection we spoke with three dentists, one dental nurse, 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 Thursday from 9am to 5pm.
Friday from 8am to 3pm.
Evenings and Saturdays by appointment only.
There were areas where the provider could make improvements. They should:
- Take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council and implement an effective system for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
- Take action to ensure audits of radiography and antimicrobial prescribing are undertaken at regular intervals to improve the quality of the service and that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
- Implement an effective system for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
- Implement an effective system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.