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 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
Hartcliffe Dental Practice Partnership is in Hartcliffe, Bristol and provides NHS and private treatment to adults and children.
There is level access for people who use wheelchairs and those with pushchairs. There was no specific practice car parking. However, there was plenty of on-street parking available near the practice.
The dental team includes two dentists and three additional long term locum dentists, one dental nurse, three trainee dental nurses, one dental hygienist, and one receptionist. The practice has three treatment rooms.
The practice is owned by a partnership 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 Hartcliffe Dental Practice Partnership is Dr Mohammed Ghafoor, the senior partner.
On the day of inspection, we collected 33 CQC comment cards filled in by patients and spoke with three other patients.
During the inspection we spoke with the principal dentist, who is also the practice manager, two locum dentists, one qualified dental nurse, three trainee dental nurses and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
8:30-5pm Monday to Friday
Our key findings were:
- The practice appeared clean and well maintained.
- The provider had infection control procedures which reflected published guidance. Although we noted a couple of areas which could be improved.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- 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 supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- Staff felt involved, supported and worked well as a team.
- 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 needed to improve how they recruited staff.
- The provider had areas where governance could be improved. This included how incidents and staff inductions were managed, and ensuring policies and procedures including current practices and were reviewed regularly.
- The systems to manage risk to patients and staff could be improved. This included managing infection control, substances hazardous to health, fire safety and staff training in infection control, medical emergencies and safeguarding.
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
- Ensure specified information is available regarding each person employed
Full details of the regulations the provider is not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
- Review the practice protocols regarding audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
- Review the practice’s protocols and procedures in relation to the Accessible Information Standard to ensure that that the requirements are complied with.
- Review the practice's procedures to ensure patient referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner and not lost.