The Whitehouse Dental Surgery

We carried out this announced focused inspection on The Whitehouse Dental Surgery 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 adviser.

To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic was visibly 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 help them manage risk to patients and staff. We noted one treatment room did not have a rectangular collimator on the intra oral X-ray unit. The practice confirmed this had been purchased immediately following the inspection.
• 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.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff 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.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved and 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 dental clinic had information governance arrangements.

Background

The Whitehouse Dental Surgery is in Buckhurst Hill, Essex and provides NHS and private dental care and treatment for adults and children.

Car parking spaces are available in the street outside the practice. There is currently a single-step access at the front of the practice during the building development, with two ground floor treatment rooms. The practice is in the process of expanding the building and making many adjustments to support patients with additional needs. These will include level access to the practice for people who use wheelchairs and those with pushchairs via automatic double wide access front doors, downstairs treatment rooms and an accessible toilet. The practice has a hearing loop and magnifying glass for patients to use.

The dental team includes five dentists, one visiting specialist, five dental nurses, one dental hygienist, one dental therapist, three receptionists and two practice managers. The practice has two treatment rooms.

During the inspection we spoke with two dentists, two dental nurses, one dental hygienist and one practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday from 8.30am to 5.30 pm.

Tuesday from 8.30am to 5 pm.

Wednesday from 8.30am to 5.30 pm.

Thursday from 8.30am to 5 pm.

Friday from 8.30am to 4 pm.

Saturday from 8.30am to 12.30 pm.

We noted innovative approaches to providing person centred care. The practice was in the process of a building development, which aimed to provide an improved patient experience including an expanded level access entrance area, a patient waiting area that opened out onto a secluded garden with seating for patients and staff. When completed, the building will have four treatment rooms, a new decontamination room, a consultation room, a recovery area for sedated patients, an office and meeting and training rooms. The provider described their plan to use media platforms to provide live interactive training for dentists and dental students from the practice training rooms. We noted highly positive feedback from patients on social media sites with feedback forms available for patients in the waiting area.

The practice had taken steps to improve environmental sustainability. For example, where possible items were recycled, the practice were moving towards a paper light service, staff were instructed to turn the power off to equipment and lighting when not in use.

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

• Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, ensure rectangular collimators are available on all intra oral X-ray units.
• Take action to ensure that dental nursing staff who assist in conscious sedation have the appropriate training and skills to carry out the role, taking into account guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015'.