Updated 18 March 2024
We carried out this announced comprehensive inspection on 13 February 2024 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 advisor.
To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:
- The dental clinic appeared clean. Processes to ensure the building was well-maintained were in place.
- The practice infection control procedures did not always reflect published guidance. Specifically in relation to safe disposal of clinical and hazardous waste.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were not available as required in national guidance.
- Systems to manage risks for patients, staff, equipment and the premises were not effective. Specifically for fire, legionella and sharps injury.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice staff recruitment procedures reflected current legislation. We found these were not always applied.
- Clinical staff provided patients’ care and treatment in line with current guidelines. There was scope for improvement in the recording of treatment completed.
- Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system worked efficiently to respond to patients’ needs.
- The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
- Processes to support effective leadership and a culture of continuous improvement where not established.
- Staff felt involved, supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- Evidence of how complaints were responded to was not available.
- The practice had information governance arrangements.
Background
Old Forge House Dental Care is in Mickleover in Derby and provides private dental care and treatment for adults and children.
There is a small step to access the practice, a portable ramp is available for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.
The dental team includes 1 dentist, 1 dental nurse and a visiting endodontist. The practice has 2 treatment rooms.
During the inspection we spoke with the dentist and the dental nurse. We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open:
Monday and Wednesday from 9am to 5pm
Tuesday from 10am to 1pm and 3pm to 8pm
Thursday from 9am to 7pm
Friday from 9am to 1pm
We identified regulations the provider was not complying with. They must:
- Care and treatment must be provided in a safe way for service users
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
Full details of the regulation the provider was not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.