Updated 26 September 2017
We carried out this announced inspection on 30 August 2017 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 provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
This followed the inspection on 12 November 2015 that had been carried out as part of our regulatory functions where breaches of legal requirements were found. The inspection on the 30 August 2017 was a comprehensive inspection and covered all key questions because the practice had been closed for a period of time following the last inspection.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five 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:
Are services safe?
We found that this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found that this practice was providing effective care in accordance with the relevant regulations.
Are services caring?
We found that this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found that this practice was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found that this practice was providing well-led care in accordance with the relevant regulations.
Background
Darfoor Dental Practice is in Westminster and provides private dental implants to adults.
The dental team includes a dentist. The dentist did not employ a full-time permanent dental nurse but instead used the services of agency nurses when they had patients. On the day of the inspection they had no dental nurse booked in as there were no patients booked for treatment. The premises consists of one treatment room which that also houses the administrative area, and a dedicated decontamination area. . The practice has access to a shared waiting area that is also used by other tenants of the building it is located in.
The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Darfoor Dental Practice was the principal dentist.
On the day of inspection we collected three CQC comment cards filled in by patients. This information gave us a positive view of the practice.
During the inspection we spoke with the dentist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open: 9.00 -5.30pm Monday to Friday.
Our key findings were:
- The practice was clean.
- The practice had infection control procedures which generally reflected published guidance.
- The dentist knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to help them manage risk.
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
- The practice had thorough staff recruitment procedures but had not recruited any staff at the time of the inspection
- The dentist generally provided patients’ care and treatment in line with current guidelines, although some improvements were required. .
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- The appointment system met patients’ needs.
- The practice asked staff and patients for feedback about the services they provided.
- The practice dealt with complaints positively and efficiently.
There were areas where the provider could make improvements. They should:
- Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
- Review availability of medicines and equipment to manage medical emergencies taking into account guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
- Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
- Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
- Review the practice’s protocols for medicines management and ensure all medicines are stored safely and securely and there is a system for identifying and disposing of out-of-date stock.
- Review the practice’s infection control procedures and protocols to take into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’