Abbey Street Dental Practice

We carried out this announced comprehensive inspection on 13 November 2023 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 and well-maintained.
• The practice infection control procedures did not consistently reflect published guidance.
• Staff knew how to deal with medical emergencies. Appropriate emergency medicines were available but not all items of life-saving equipment were available.
• The practice had some systems to manage risks for patients, staff, equipment and the premises. Additional risks were highlighted by the inspection in relation to fire safety, radiation protection, sharps safety, staff immunity, prescription security and electrical safety.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• 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.
• We found leadership and oversight of the service had lapsed in some areas.
• Staff felt involved, supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements. The CCTV policy should be reviewed and updated.

Background

Abbey Street Dental Practice is in Accrington, Lancashire and provides NHS and private dental care and treatment for adults and children. The provider has another dental practice in nearby Darwen.

There is a small step at the front entrance to the premises, a portable ramp is provided for people who use wheelchairs and those with pushchairs. On street parking is available near the practice. Reasonable adjustments have been made to support patients with access requirements. The practice does not have an accessible toilet.

The dental team includes 2 dentists and an implant dentist who attends when required, 4 dental nurses, 1 dental therapist, 1 practice manager and a receptionist. The practice has 2 treatment rooms.

During the inspection we spoke with 1 dentist, 1 dental nurse, 1 receptionist and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday 9am to 6.30pm

Tuesday, Wednesday and Thursday 9am to 5.30pm

Friday 7.45am to 3.30pm

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

• 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:

• Implement protocols for the use of closed-circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.

• Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.