Soutergate Dental Practice

We carried out this announced focused inspection on 9 August 2022 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 adviser.

To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• 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 to be visibly clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available, with the exception of some sizes of clear face masks.
• The practice had systems to help them manage risk to patients and staff. We discussed how some of these could be strengthened.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. Some policy details needed updating.
• The practice had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• There was effective leadership and a culture of continuous improvement. Some audits were not being completed within recommended cycles.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• The dental clinic had information governance arrangements.

Background

The provider has two practices in the area and this report is about Soutergate Dental Practice.

Soutergate Dental Practice is in Ulverston, Cumbria and provides private dental care and treatment for adults and children.

The practice is located on a road called Soutergate, in the town of Ulverston. The practice is accessed from pavement level with only a small step. However, it is not suitable for patients with limited mobility as the dental treatment rooms are located on the first floor, accessed via a staircase only. The provider can direct patients to another practice nearby, which is more accessible for those with limited mobility. Car parking spaces are available near the practice in a pay and display car park.

The dental team includes the principle dentist, three dental nurses, one of whom is a trainee, one dental hygienist and the practice business manager.

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

The practice is open Monday to Thursday from 9am to 5pm and closed each day for an hour for lunch between 1pm and 2pm. The practice is open on Friday from 8am to 4pm and closed for lunch between 12pm and 1pm.

There were areas where the provider could make improvements. They should:

Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry, and audits of patient dental care records to check that necessary information is recorded.

Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.

Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular:

• that all required items of emergency kit are itemised to assist in checks on the availability and readiness of these items;
• that nurses follow the practice sharps policy and that all sharps are dismantled by the dentist;
• that a suitable rectangular collimator is brought into use on radiography equipment;
• that details of the Care Quality Commission (CQC) are added to the safeguarding policy and that details of the CQC and the General Dental Council (GDC) are added to the whistle blowing policy.