We carried out this announced inspection on 22 November 2017 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 Care Quality Commission (CQC) inspector who was supported by a specialist dental adviser.
We told the NHS England area team that we were inspecting the practice. They did not provide any information.
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 not providing well-led care in accordance with the relevant regulations.
Background
Woodlane Dental Practice is located in Dagenham, in the London Borough of Barking and Dagenham. The practice provides NHS and private dental treatments to patients of all ages.
The practice is located on the ground floor of a purpose adapted premises. The practice has one treatment room. The practice is conveniently located close to public transport links.
The dental team includes the principal dentist and one associate dentist, three trainee dental nurses and a receptionist.
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.
We received feedback from 13 patients via CQC comment cards. This information gave us a positive view of the practice.
During the inspection we spoke the principal dentist and the trainee dental nurses. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open between 9am and 5.30pm on Mondays to Fridays.
Our key findings were:
- The practice was clean and well maintained.
- The practice 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.
- The appointment system met patients’ needs.
- The practice asked staff and patients for feedback about the services they provided.
- The practice dealt with complaints positively and efficiently.
- The practice had limited arrangements to report, investigate, respond and learn from accidents, incidents and significant events.
- There were limited arrangements to protect patients and staff from accidental exposure to substances which may be hazardous to health such as cleaning and other materials.
- The practice had safeguarding processes and procedures. However staff had not undertaken training and staff were unclear about their responsibilities for safeguarding adults and children.
- The practice had infection control procedures which reflected published guidance. However there were limited systems for quality assurance of these procedures in line with published guidance.
- Staff did not know how to deal with emergencies or the proper use and storage of some emergency equipment.
- The practice had some systems to help them assess and manage risk. However these were not always consistent or in line with current guidance and legislation.
We identified regulations the provider was not meeting.
They must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.
Full details of the regulations the provider was not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
- Review the practice’s audit protocols to ensure infection control audits are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.
- Review the systems for checking and monitoring equipment taking into account current national guidance and ensure that all equipment is well maintained.
- Review the protocols and procedures for use of X-ray equipment taking into account Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment.
- Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.