Precious Dental Care

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We found this practice was not providing well-led care in accordance with the relevant regulations. We will be following up on our concerns to ensure the provider had made the required improvements.

During our inspection of this key question, we found:

The registered person had ineffective systems or processes to enable them to assess, monitor and improve the quality and safety of the services being provided. We also found ineffective systems or processes to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk.

The registered person did not have effective systems to maintain records as are necessary to be kept in relation to persons employed. This included information relating to the requirements under Regulations 4 to 7 and/or Regulation 19 of this part (part 3) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This resulted in a breach of Regulation 17, Good governance.

You can find more details of our concerns in the detailed findings below.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Shared direction and culture is based on the latest evidence we assessed for the Well-led key question.

The judgement for Capable, compassionate and inclusive leaders is based on the latest evidence we assessed for the Well-led key question.

The judgement for Freedom to speak up is based on the latest evidence we assessed for the Well-led key question.

The judgement for Workforce equality, diversity and inclusion is based on the latest evidence we assessed for the Well-led key question.

The current systems of governance which included policies and procedures did not enable the provider to identify where quality and safety was being compromised and to respond appropriately and without delay. The practice had a compliance programme to support governance. However, this is not being used effectively. The recruitment, infection prevention and control and incident policies were not being followed.

Staff did not have clear responsibilities, and systems of accountability to support good governance. There was no evidence staff in lead roles had been active in these roles. For example, fire safety and infection prevention and control.

The provider did not establish and operate systems and processes to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users.

Significant risks were identified with the arrangements to respond to medical emergencies, cleanliness and infection prevention and control, radiation protection, fire safety, Legionella, electrical safety, and the servicing of equipment.

The provider had not implemented systems for reviewing and investigating when things went wrong. There were ineffective processes for identifying and investigating incidents and significant events. We identified issues during the inspection which should have been documented as significant events. Opportunities were missed to ensure learning and prevent reoccurrence of these issues. In particular, we reviewed an incident involving a contaminated sharps injury where incomplete information was used to assess risk.

The practice did not have systems and processes for learning, quality assurance and continuous improvement. Audits were ineffective and did not highlight risk and areas for improvement.

Staff feedback was obtained through meetings and informal discussions. They said where issues were raised these were not acted upon. For example, staff told us the entire block of base unit cabinetry in the ground floor rear surgery had suddenly dropped and separated from the unit above approximately a year ago. This had been reported but there was no evidence of action to risk assess or obtain advice to identify the reason for this, such as if there was a structural issue that could further deteriorate.

In response to this inspection, the provider took action to address the highest risks to ensure the safety of patients. They confirmed new procedures would be introduced and training provided for staff to ensure these are followed. We will be following up on our concerns to ensure these are implemented and embedded.

There were effective processes for receiving and acting on safety alerts. We highlighted a system should be in place to keep track of alerts acted on.

Staff were aware of the importance of protecting patients’ personal information. Staff password protected patients’ electronic care records, and paper records were stored securely and complied with General Data Protection Regulations.

The judgement for Partnerships and communities is based on the latest evidence we assessed for the Well-led key question.

The judgement for Learning, improvement and innovation is based on the latest evidence we assessed for the Well-led key question.