Archived: Grange Green Dental Practice

Updated 23 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was carried out to follow up on anonymous concerns raised about infection control procedures at the practice and to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We carried out an unannounced, focused inspection on 17 October 2016. The inspection team consisted of a Care Quality Commission (CQC) inspector and a dental specialist advisor.

During the inspection, we spoke with the principal dentist, one trainee dental nurse and one receptionist. We reviewed policies, procedures and other documents in relation to the management of the dental practice.

Two previous comprehensive inspections had been carried out at the dental practice. The first inspection was carried out in April 2016 during which, we found that the practice was not providing safe and effective care in line with current regulations. We identified serious concerns and breaches of regulations in relation to infection control, good governance and staff recruitment. We took enforcement action and issued warning notices, which described the action that the dental provider was required to take to secure the necessary improvements.

We carried out a second inspection in July 2016. At this time we found that the provider had implemented systems to address the concerns identified. However, at our inspection in October 2016 we found these systems were not fully embedded into practice and the risks to the safety of patients and staff in the practice had increased.

Updated 23 February 2017

We carried out an unannounced focused inspection on 17 October 2016 following concerns raised anonymously about infection control procedures at the practice.

Our findings were:

Are services safe?

We found that this practice was not providing safe care in accordance with the aspects of the relevant regulations which we inspected.

Are services well-led?

We found that this practice was not providing well-led care in accordance with the aspects of the relevant regulations which we inspected.

Background

Grange Green Dental Practice is a private dental practice situated in a converted property in Billericay, Essex. The practice offers a range of preventative, general and cosmetic dental treatments to adults and children.

The practice has three treatment rooms, a combined waiting room and a reception area. Decontamination takes place within treatment a dedicated decontamination room (Decontamination is the process by which dirty and contaminated instruments are bought from the treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

There is a small car park at the front of the building and on street parking is available. There is step free access to the premises.

The practice has a principal dentist, three dental nurses and one receptionist. Two dental hygienists provide services to the practice.

The provider is registered with the Care Quality Commission (CQC) as an organisation. The principal dentist is the registered manager Like registered providers; they are ‘registered persons’. Registered persons 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 practice is open on Monday and Tuesday from 8.30am to 5.30pm, Wednesday from 8.30am to 7pm, Thursday from 8.30am to 5pm and Friday 8.30am to 4pm. The practice closes between 1pm and 2pm for lunch.

Our key findings were:

• The practice did not have effective systems in place for sharing information. There were a range of policies and procedures in place in relation to several aspects of care; however staff who we spoke with were unable to demonstrate that they were aware of, understood or followed these.
• The practice had safeguarding policies and procedures in place and staff we spoke with were able to demonstrate that they understood their responsibilities to report concerns about the safety and welfare of patients.
• The practice had a whistleblowing policy. Staff we spoke with did not feel confident to report concerns without fear of recrimination.
• Processes to manage risks with respect to infection control were not effective. Staff we spoke with could not demonstrate that they fully understood or followed these procedures. Infection control procedures were not carried out in line with current guidelines and there were no arrangements for monitoring procedures.
• There were ineffective measures in place to assess and minimise the risk of legionella.
• There were ineffective processes in respect of assessing and mitigating risks to the health and safety of patients and staff.
• There were ineffective procedures in place for disposing of hazardous waste materials.
• The practice had the recommended range of medicines and equipment for dealing with medical emergencies. However some medicines were not stored correctly in line with the manufacturer’s instructions.
• There were ineffective arrangements for supervising and supporting staff to carry out their duties safely and in line with current guidelines.
• There were ineffective governance arrangements in place to assess, monitor and improve the quality and safety of services provided.

At the time of finalising the inspection report the dental provider had sold the dental practice and cancelled their registration. The enforcement action against the dental provider was therefore cancelled.