West Mersea Dental Practice

We carried out this announced focused inspection on 11 March 2022 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 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 to be visibly clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate emergency medicines and most life-saving equipment were available. The practice confirmed missing equipment including face masks sizes 0, 3 and 4 were ordered immediately after the inspection.
• The practice had systems to help them manage risk to patients and staff.
• The five yearly electrical fixed wire testing had not been undertaken.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The consent policy did not fully reflect the Mental Capacity Act 2005 and Gillick competency. Not all staff were aware of their responsibilities in relation to these and their responsibilities under the Mental Capacity Act as it relates to their role.
• 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.
• Audits of antimicrobial prescribing were not undertaken.

Background

West Mersea Dental Practice is in West Mersea on the island of Mersea off the coast of Essex and provides NHS and private dental care and treatment for adults and children. The practice is the only dental practice on the island, reached by a causeway which can be flooded by seasonal and spring high tides.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice. The practice has made reasonable adjustments to support patients with additional needs.

The dental team includes three dentists, nine dental nurses including one trainee dental nurse, one dental hygienist, two receptionists and a practice manager. The practice has three treatment rooms.

During the inspection we spoke with two dentists, four dental nurses, one receptionist 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 from 8.30am to 5.30pm.

Friday from 8.30am to 5pm.

The practice had taken steps to improve environmental sustainability. For example, where possible items were recycled, 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:

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
• Improve and develop the consent policy and ensure staff awareness of the requirements of the Mental Capacity Act 2005 and Gillick competency and ensure all staff are aware of their responsibilities in relation to this and their responsibilities under the Act as it relates to their role.
• Take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Take action to ensure the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular, ensure five yearly electrical fixed wire testing is undertaken.