• Dentist
  • Dentist

Dental Excellence

Unit 17, The Matchworks, Speke Road, Garston, Liverpool, L19 2RF (0151) 729 0000

Provided and run by:
Dr Robert John Hughes

All Inspections

1 July 2020

During an inspection looking at part of the service

We undertook a desk-based follow-up inspection of Dental Excellence on 1 July 2020. 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.

We undertook a comprehensive inspection of Dental Excellence on 10 December 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 and was in breach of regulation 17 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 Dental Excellence on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

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 area where improvement was required.

This desk based follow-up inspection was carried out during the COVID 19 pandemic. Due to the demands and constraints in place because of COVID 19 we reviewed the action plan submitted by the provider following our inspection of December 2019, alongside evidence the provider supplied to demonstrate how they were maintaining these improvements.

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breach we found at our inspection on 10 December 2019.

Background

Dental Excellence is based on a business park in the Garston area of Liverpool and provides 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 are available immediately outside the practice.

The dental team includes the principal dentist, three dental associates, eight dental nurses, one of whom is a trainee, two dental hygiene therapists, three administrators and a practice manager. The practice retains the services of two advanced dental implantologists, a specialist endodontist and a specialist oral surgeon. The practice has six treatment rooms.

The practice is owned by an individual who is the principal dentist there. 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.

During the inspection we spoke with one of the dentists who presented us with evidence of improvements made, supported by the practice compliance manager. We also looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday 9am to 6pm, Friday from 9am to 4pm, and on Saturdays by arrangement between 2pm and 6pm.

Our key findings were:

The provider had reviewed all aspects of governance within the practice, including areas highlighted at our previous inspection. We found:

  • Improvements had been made in relation to management and control of Legionella, including removal of any little used outlets and regular water temperature checks in support of the management of risk of Legionella.
  • Improved and more frequent audit in respect of infection control.
  • Improved training for staff on how to conduct more effective audit, in different areas across the practice.
  • Effective review of all staff files and recruitment documents held. We found all records required to be held where in place.
  • Appraisal was now in place for all staff.
  • Improved response to critical acceptance testing reports in relation to X-ray equipment at the practice, addressing recommendations made.
  • Policies and protocols to promote safe working and effective governance had been reviewed.
  • Improvement of systems and processes in place to support good communication.
  • Practice meetings were planned and held on a regular basis. These were minuted, so that any staff member absent on that day, could review any updates and actions required.

10 December 2019

During a routine inspection

We carried out this announced inspection on 10 December 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 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 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Dental Excellence is based on a business park in the Garston area of Liverpool and provides 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 are available immediately outside the practice.

The dental team includes five dentists, eight dental nurses, one of whom is a trainee, two dental hygiene therapists, three administrators and a practice manager. The practice has six treatment rooms.

The practice is owned by an individual who is the principal dentist there. 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.

On the day of inspection, we collected 18 CQC comment cards filled in by patients. All feedback provided was highly positive.

During the inspection we spoke with one dentist, one dental therapist, a dental nurse, one administrator 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 Thursday 9am to 6pm, Friday from 9am to 4pm, and on Saturdays by arrangement between 2pm and 6pm.

Our key findings were:

  • The practice appeared to be visibly clean and well-maintained.
  • The provider had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The provider had systems to help them manage risk to patients and staff. Some recommendations from risk assessments had not been actioned and some risk assessments could be further developed.
  • The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had staff recruitment procedures which reflected current legislation. Some records relating to staff recruitment were not held by the provider.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • 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.
  • Staff felt involved and supported and worked as a team.
  • The provider asked staff and patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • The provider had information governance arrangements. Some practice related areas of governance required improvement.

We identified regulations the provider was not complying with. 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 is at the end of this report.

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

  • Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.