Archived: Apex Dental Group Limited

We carried out an unannounced comprehensive inspection on 28 November 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

The Green Dental Practice, located in North Finchley, London provides NHS and private dental treatment to patients of all ages. The services provided include preventative advice and treatment and routine dental care.

The practice staffing consists of a principal dentist, one dentist, one dental nurse, one hygienistand a receptionist.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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 consists of one treatment room, Decontamination room a waiting area for patients and reception area

The practice opening hours are Monday 2pm to 6pm, every other Tuesday 2pm to 6pm and Wednesday 10am to 6pm.

Patients we spoke with and those who were very positive about the care they received and about the service. Patients told us that they were happy with the dental treatment and advice they had received.

Our key findings were:

• Patients’ care and treatment was planned and delivered in line with current legislation and evidence based guidelines such as from the National Institute for Health and Care Excellence (NICE).
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Patients were treated with dignity and respect and patient confidentiality was maintained.

• The practice had a procedure for handling and responding to complaints.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• The practice had arrangements for receiving and responding to patient safety alerts issued from relevant external agencies.

• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
• Infection control protocols were not being followed in line with recommended national guidance.

• There were systems in place to ensure that equipment including the suction apparatus, X-ray unit was maintained and PAT (portable appliance testing) had been carried out. However, servicing was overdue for the compressor unit, autoclave and fire extinguishers..

• Governance systems were not effective. The practice had not carried out audits in key areas, such as radiography and record keeping. The practice had carried out limited risk assessments to safeguard the health and safety of staff and patients.

• The practice had not ensured that all the specified information relating to persons employed at the practice was obtained and appropriately recorded.

We identified regulations that were not being met and the provider must:

• Ensure an effective system is established to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.
• Ensure systems are in place to assess, monitor and improve the quality of the service such as undertaking regular audits of various aspects of the service and ensuring that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.
• Ensure the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely .
• Review the practice’s infection control procedures and protocols taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’
• Review 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.
• Review stocks of medicines and equipment and the system for identifying and disposing of out-of-date stock.
• 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.
• Review the practice protocol and ensure staff are aware of their responsibilities as per the Duty of candour under The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

• Review the staff supervision protocols and ensure an effective process is established for the on-going appraisal of all staff.