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Dental Practice - Barkingside

Inspection Summary


Overall summary & rating

Updated 3 June 2019

We undertook a follow up focused inspection of Dental Practice - Barkingside on 11 April 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Dental Practice - Barkingside on 14 November 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe, effective or well led care and was in breach of regulation 12 - Safe care and treatment, 17 – Good governance, 18 - Staffing and 19 - Fit and proper persons employed of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Dental Practice - Barkingside on our website www.cqc.org.uk.

  • Is it safe?

  • Is it effective

  • Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations. The provider had made improvements in relation to the regulatory breach we found at our inspection on 14 November 2018.

Are services effective

We found that this practice was providing effective care in accordance with the relevant regulations. The provider had made improvements in relation to the regulatory breach we found at our inspection on 14 November 2018.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breach we found at our inspection on 14 November 2018.

Background

Dental Practice - Barkingside is in Ilford in the London Borough of Redbridge. The practice provides NHS and private treatments to patients of all ages. The practice is situated close to public transport bus services.

The dental team includes the principal dentist who owns the practice, one associate dentist, one specialist periodontist and two dental nurses.

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.

During the inspection we spoke with the principal dentist, one associate dentist and two dental nurses.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 9am to 5.30pm.

Our key findings were:

  • There were arrangements to assess and mitigate risks of infection. There were systems to ensure that single use dental instruments were disposed of and not available for re-use. Clinical waste was disposed of properly and safely.

  • There were arrangements in place for ensuring that all relevant staff had suitable immunity against vaccine preventable infectious diseases. The practice’s sharps procedures were in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

  • There were arrangements to assess and mitigate risks associated with infection prevention and control and Legionella.

  • There were arrangements to monitor and improve quality in relation to dental radiography though a system of audits.

  • There were processes in place to ensure the on-going supervision and appraisal for staff.

  • There were systems in place to ensure that staff undertook training and periodic training updates in areas relevant to their roles including training in safeguarding children and vulnerable adults and training in infection control.

  • There were processes to ensure that appropriate checks were carried out including determining for each person employed their identity, employment history, proof of conduct in previous employment and registration with their appropriate professional body.

  • There were systems to ensure that dental care products and medicines requiring refrigeration were stored in line with the manufacturer’s guidance.

  • There were arrangements to minimise risks associated with the use and handling of hazardous substances, taking into account the Control of Substances Hazardous to Health (COSHH) Regulations 2002.

  • The practice had protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.

  • Information in relation to safety including patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) were reviewed and shared to help monitor and improve safety.

  • Improvements had been made to the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

  • There were systems to ensure that urgent and routine referrals were monitored suitably.

  • Improvements had been made to the arrangements to respond to the needs of patients with disability and the requirements of the Equality Act 2010.

Inspection areas

Safe

No action required

Updated 3 June 2019

We found that this practice was providing safe care and was complying with the relevant regulations.

The practice had made improvements to the systems and processes to provide safe care and treatment.

Improvements had been made to the procedures followed when recruiting new staff to ensure that all of the essential checks were undertaken.

There were arrangements to ensure the practice policies and procedures in relation to safety were in accordance with current legislation and guidelines and that staff understood and followed procedures.

Improvements had been made to ensure that single use items were not re-used and that clinical waste was disposed of safely and appropriately.

There were suitable arrangements to ensure that staff had appropriate vaccinations.

Improvements were also noted to the systems in place to ensure that appropriate risk assessments were carried out. The risks associated with infection control, hazardous substances, dental sharps and Legionella were assessed and there were arrangements in place to minimise these.

Effective

No action required

Updated 3 June 2019

We found that this practice was providing effective care and was complying with the relevant regulations.

Improvements had been made to the arrangements to ensure that the dentists assessed patients’ needs and provided care and treatment in line with recognised guidance.

Improvements had been made so that patients’ dental records were complete, accurate and detailed and included information to demonstrate that patients understood and consented to their care and treatment.

The practice had reviewed its protocols for referral of patients and there were systems to ensure that routine and urgent referrals were made suitably and that urgent referrals were followed up promptly.

There were arrangements in place to ensure that staff were supported to complete training relevant to their roles and there were systems to monitor this.

Caring

No action required

Updated 28 February 2019

We found that this practice was providing caring services in accordance with

the relevant regulations.

We received feedback about the practice from 25 people. Patients were positive about how they were treated. They told us staff were

caring, friendly and understanding

.

Patients said that their dentist listened to them and helped them to understand the treatment provided including any options available.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 28 February 2019

We found that this practice was providing responsive care in accordance with the relevant regulations.

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain. Patients commented that they received treatment in a timely manner.

Staff considered patients’ different needs and had made arrangements to support them. There was step free access to the practice and accessible toilets facilities were available which were fitted with a handrail. The practice also had a hearing loop. Improvements were needed so that a Disability Access audit was completed and kept under review so that the practice could provide support to patients as far as was practicable.

The practice had arrangements to help patients whose first language was not English and those with sight or hearing loss should these be required.

The practice had arrangements to respond to and deal with complaints.

Well-led

No action required

Updated 3 June 2019

We found that this practice was providing well-led care and was complying with the relevant regulations.

Improvements had been made to the oversight and management systems for the day to day management of the practice.

There were systems in place to ensure that policies and procedures were bespoke to the practice, in accordance with current legislation and that they were understood and adhered to by the staff team.

There were arrangements in place to assess and mitigate risks in relation to Legionella and infection prevention and control.

Improvements had been made to the systems to audit and review clinical and non-clinical aspects of the service.