Caizen Dental

We carried out this announced inspection on 28 May 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 not 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

Caizen Dental is in Minster-on-sea in Sheerness and provides private treatment to adults.

There is level access for people who use wheelchairs via a small ramp. Car parking spaces, including some for blue badge holders, are available near the practice.

The dental team includes one dentist and one student dental nurse 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.

On the day of inspection, we collected 12 CQC comment cards filled in by patients and spoke with two other patients.

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:

Thursday 9am to 5pm

Friday 9am to 5pm

Saturday 9am to 3pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which did not wholly reflect published guidance.
• Not all staff were sure with how to deal with emergencies. Appropriate medicines were available, however some life-saving equipment was not.
• The practice 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. However safeguarding training had not been completed.
• 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 were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and 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.

We identified regulations the provider was not complying with. They must:

• Obtain sufficient quantities of equipment to ensure the safety of service users and to meet their needs. In particular: the practice did not have equipment as per the resuscitation council guidance for medical emergencies
• Ensure people providing care and treatment had the competence, skills and experience to do so safely. In particular: training had not been completed for safeguarding both vulnerable adults and children and medical emergencies.
• Ensure proper and safe management of medicines. In particular: we noted that medicines held for dispensing were not secure.
• Create systems or processes that enabled the registered person to evaluate and improve their practice in respect of the processing of the information obtained throughout the governance process. In particular: no audits had been conducted with regard to the quality of x-rays and infection control.

Full details of the regulation/s the provider was/is not meeting are at the end of this report.

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

• Consider broadening the scope of audit systems. In particular, by the inclusion of antimicrobial prescribing and dental implant procedures.