Cathedral Dental Practice

We carried out this announced comprehensive inspection on 27 April 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 had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to manage risks for patients, staff, equipment and the premises.
• 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.
• There was effective leadership and a culture of continuous improvement.
• 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.

Background

Cathedral Dental Practice is in Bury St. Edmunds, Suffolk and provides private dental care and treatment for adults and children.

A portable ramp is available for access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 5 dentists (including 1 visiting specialist), 6 dental nurses including 2 trainee dental nurses, 3 dental hygienists, 1 dental therapist, 2 treatment coordinators, 2 administrators, 1 support staff, 1 practice manager and 2 receptionists. The practice has 4 treatment rooms.

During the inspection we spoke with 2 dentists, 3 dental nurses, 2 receptionists,1 support staff and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open on Mondays to Thursdays from 9am until 8pm, on Fridays from 9am until 3pm and on Saturdays from 9am until 4pm.

The practice had taken steps to improve environmental sustainability. For example, reducing printing of documents, turning electricity off when not required and recycling where possible.

We noted innovative approaches to providing person centred care. The practice were pioneering the use of Artificial Intelligence (AI) technology through a mobile application that enabled patients to scan and send images of their teeth to the practice. This technology allowed for the continual monitoring of patients' oral health progress, especially those using invisible aligners or braces. The Dental Monitoring lead highlighted the benefits of this system, which included a reduction in face-to-face appointments, weekly remote access for patients, automatic alerts for detected conditions, video consultations with dental professionals, and a quick diagnosis of oral health issues. This system had already identified potential oral health issues, such as developing cavities, and the practice was actively expanding the use of this system to monitor other oral health conditions.

The practice had also introduced AI technology in their radiography processes. An AI platform automatically detected numerous conditions in dental X-rays, providing a second set of eyes or opinion for radiologic accuracy.

Additionally, in response to the pandemic, the practice team decided to retain their late-night and Saturday appointments. The practice is open until 8 pm four nights a week and offers appointments on Saturdays from 9 am to 4 pm for patients unable to attend during regular working hours.