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Inspection Summary


Overall summary & rating

Updated 15 March 2019

We undertook a follow up inspection of Chigwell Smile on 7 February 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 Chigwell Smile on 28 June 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. As a result of that inspection, we found the registered provider was not providing well led care and was in breach of regulation 17 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 Chigwell Smile on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

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 28 June 2018.

Background

Chigwell Smile is in Chigwell, Essex and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes two dentists, three dental nurses, one dental hygienist and a receptionist. The practice has three treatment rooms.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Chigwell Smile is the principal dentist.

During the inspection we spoke with two dentists, one dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday from 8am to 1pm and from 2pm to 5.30pm. Friday from 8am to 1pm and from 2pm to 5pm.

Our key findings were:

  • There were effective systems and processes in place to ensure good governance in accordance with the fundamental standards of care.
  • Staff had undertaken training on the requirements of the Mental Capacity Act 2005 and were aware of their responsibilities under the Act and how it related to their role. In addition, staff were aware of Gillick competency and their responsibilities in relation to this.
  • Staff had a clear awareness of the need for the practice to establish parental responsibility when seeking consent for children and young people.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • Systems were in place to ensure X-ray and decontamination equipment was maintained in line with manufacturers recommendations’.
  • Legionella risk assessments were undertaken and any recommended actions completed.
Inspection areas

Safe

No action required

Updated 15 March 2019

Effective

No action required

Updated 15 March 2019

Caring

No action required

Updated 15 March 2019

Responsive

No action required

Updated 15 March 2019

Well-led

No action required

Updated 15 March 2019

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

The provider had made improvements to the management of the service. This included more robust systems for monitoring, assessing and improving the quality and safety of the service. Systems were in place to monitor the servicing of equipment used for X-ray and decontamination.

A legionella risk assessment had been undertaken and any recommended actions had been monitored and completed. There was improved staff training which included staff understanding of Gillick competency and their responsibilities in relation to this, parental responsibility and the review and analysis of untoward events.

We saw record keeping and infection control audits had been undertaken in line with guidance and there was improved oversight and peer review of audits by both dentists.

The improvements provided a sound footing for the ongoing development of effective governance arrangements at the practice.