Updated 30 August 2019
We carried out this announced inspection on 24 July 2019 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.
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 not 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 not providing well-led care in accordance with the relevant regulations.
Background
Finest Dental Bermondsey is in Bermondsey in the London Borough of Southwark. The practice provides dental implants to adults on a private paying basis.
The practice is located close to public transport services. The practice has two treatment rooms both located on the ground floor.
The dental team includes the principal dentist, two associate dentists, one dental nurse and one trainee dental nurse. The dental team are supported by a practice manager and three treatment coordinators.
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 Finest Dental Bermondsey is the principal dentist.
We collected feedback from six patients who completed CQC comment cards.
During the inspection we spoke with the principal dentist, the practice manager, one dental nurse and two treatment coordinators. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Between 9am and 6pm on Mondays, Wednesdays and Fridays.
Between 10am and 8pm on Tuesdays and Thursdays.
Our key findings were:
- The premises appeared clean and well maintained.
- Staff treated patients with dignity and respect and 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.
- The provider asked patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- The provider had suitable information governance arrangements.
- The provider had infection control procedures which reflected published guidance. Improvements were needed so that infection control audits were carried out in line with current guidance.
- There were ineffective arrangements to deal with emergencies. Some of the recommended medicines and life-saving equipment were not available.
- The provider’s systems to help them manage risk to patients and staff required improvement.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. Improvements were needed so that staff undertook safeguarding training.
- There were no arrangements to gain assurances in relation to sedation equipment checks or the sedationists’ qualifications and skills.
- The provider’s staff recruitment procedures were not followed and the required documentation was not available.
- There were ineffective arrangements to support staff and ensure that they completed training including continuing professional development (CPD)
- The provider did not have effective leadership to support continuous improvement.
Following discussions with the principal dentist they assured us that the practice would cease providing dental treatment procedures under conscious sedation until such time as they had reviewed their procedures and addressed the issues and concerns we identified.
We identified regulations the provider was not complying with. They must:
- Ensure care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development and supervision necessary to enable them to carry out the duties.
- Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
Full details of the regulations the provider was not meeting are at the end of this report.
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 by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.