Archived: All Saints Dental Clinic

We carried out this unannounced inspection on 16 December 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 Care Quality Commission (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 not 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

All Saints Dental Clinic is in Kensington, London and provides NHS and private treatment to adults and children.

There are car parking spaces, including some for blue badge holders available near the practice.

The dental team includes a dentist, a dental nurse and a practice manager. The practice has one treatment room and a separate decontamination room.

The practice is owned by an individual who is the principal dentist. They have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we received feedback from three patients.

During the inspection we spoke both with the dentist, the dental nurse and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice appeared to be generally clean.

• The dentist provided patients’ care and treatment in line with current guidelines.
• The dentist provided preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider did not have an effective and accessible system for identifying, receiving, handling and responding to complaints from people using the service, people acting on their behalf or other stakeholders.
• Staff had some understanding of how to deal with medical emergencies. However, some medicines and life-saving equipment were unavailable on the day of the inspection. These were procured immediately by the provider.
• The provider did not have effective systems in place to manage risks such as for example, in regard to ensuring equipment used at the practice was regularly serviced.

The practice staff did not have effective understanding, awareness and access to policies to help identify and report abuse of service users.

• The provider did not carry out all the required recruitment checks for staff employed.
• The provider did not have systems in place to audit their non-clinical and clinical processes.
• The provider did not have effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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

• Ensure care and treatment is provided in a safe way to patients.
• Ensure patients are protected from abuse and improper treatment.
• Ensure there is an effective system for identifying, receiving, recording, handling and responding to complaints by patients and other persons in relation to the carrying on of the regulated activity.
• 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.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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 protocols regarding audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Review the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
• Implement processes and systems for seeking and learning from patient and staff feedback with a view to monitoring and improving the quality of the service.