Andrew Hargreaves Dental Practice

We carried out this announced focused inspection on 28 March 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 emergency medicines and most life-saving equipment were available. Missing equipment including, a paediatric self-inflating bag, masks and an airway were ordered immediately after the inspection.
• The five yearly electrical fixed wire testing had not been undertaken, however the provider sent us evidence this had been completed following the inspection.
• 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. However, we found references missing for the newest member of staff.
• 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, however not all required audits were completed to ensure a culture of continuous improvement.
• Staff felt involved and 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 dental clinic had information governance arrangements. However, there were not always clear and effective processes for managing risks, issues and performance. For example, x-ray equipment had not been serviced.

Background

Andrew Hargreaves Dental Practice is in Stourbridge, West Midlands and provides NHS and private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice. The practice has made reasonable adjustments to support patients with additional needs.

The dental team includes one dentist, one dental nurse and two part time receptionists. The practice has one treatment room.

During the inspection we spoke with one dentist, one dental nurse and one receptionist.

The practice is open:

• Monday 9am to 1pm, 2pm to 4.30pm
• Tuesday 9am to 1pm, 2pm to 5pm
• Wednesday 9am to 1pm, 2pm to 6pm
• Thursday 9am to 1pm, 2pm to 6pm
• Friday 9am to 1pm

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

• Take action to ensure audits of radiography, infection prevention and control, antimicrobial prescribing and patient clinical notes are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
• Take action to implement any recommendations in the practice's Legionella risk assessment, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular, ensure, hot water sentinel checks are over the required 55 degrees and the hot and cold water temperatures are checked every month.
• Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment.
• Develop systems to ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff. Including the training, learning and development needs.