Updated 12 August 2019
We undertook a follow up focused inspection of The Dental Practice on 27 June 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 had remote access to a specialist dental adviser.
We undertook a comprehensive inspection of The Dental Practice on 9 January 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care in accordance with the relevant regulations 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 The Dental Practice on our website www.cqc.org.uk.
When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.
As part of this inspection we asked:
• Is it well-led?
Our findings were:
Are services well-led?
We found this practice was not providing well-led care in accordance with the relevant regulations. The provider had made some improvements, these were insufficient to put right the shortfalls we found at our inspection on 9 January 2019.
Background
The Dental Practice is in Bolton and provides NHS and private treatment to adults and children.
A portable ramp is provided for people who use wheelchairs and those with pushchairs. On street parking is available near the practice.
The dental team includes three dentists, four dental nurses (one of whom also manages the practice) and a dental hygiene therapist. The practice has three treatment rooms.
The practice is owned by a partnership but is registered as an individual provider. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. We again highlighted the need to ensure the practice is registered correctly.
During the inspection we spoke with one dentist 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 Friday 8.45am to 12.15pm and 1.45pm to 5.15pm
Our key findings were:
- Emergency medicines and life-saving equipment were in line with Resuscitation Council UK standards. Advice had not been followed to obtain additional adrenaline.
- Staff recruitment procedures were not effective. A DBS check and references had not been obtained for a new clinical member of staff. There was no evidence of an induction.
- Practice policies and procedures had been improved.
- A system to log and track NHS prescriptions had been implemented.
- The provider had infection control procedures which reflected published guidance. Improvements could be made to the treatment environment and processes to audit standards of infection prevention and control.
- The systems to identify and manage risk required improvement.
- Sharps safety had been reviewed. There were clear processes to follow up sharps injuries
- The practice had not established systems to ensure staff were up to date with training and development.
We identified regulations the provider was not meeting. 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 is not meeting are at the end of this report.