23 Cosmetic Dental Clinic

We carried out this announced comprehensive inspection on 22 March 2023 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 remotely by a specialist dental advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:

• The dental clinic appeared clean and well-maintained.
• The practice had infection control procedures which reflected published guidance. Some improvements could be made to ensure adherence to published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had some systems to help them manage risk to patients and staff. Improvements should be made to the system, to ensure the practice managers have oversight of any recommendations from the fire risk assessments. Stock control protocols were needed as part of the management of medicines.
• 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.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved, 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 practice had information governance arrangements.

Background

The provider is part of a dental group, with multiple practices. This report is about 23 Cosmetic Dental Clinic.

The practice is in Morpeth and provides NHS and private dental care and treatment for adults and children.

The practice is accessible for people who use wheelchairs and those with pushchairs. The practice is located close to local transport routes and car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 8 dentists, 10 dental nurses, 3 trainee dental nurses, 2 dental hygienists, 2 practice managers, 1 treatment coordinator and 1 receptionist. The practice has 5 treatment rooms.

During the inspection we spoke with 2 dental nurses, 1 trainee dental nurse, the practice managers and the dental group’s area quality lead. As we did not speak to any dentists on the day of the inspection we carried out a remote conversation with 2 of the dentists after the inspection. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday, Wednesday and Friday from 7.50am to 5.50pm

Tuesday and Thursday from 7.50am to 7.50pm

Saturday from 9am to 4pm

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

• Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’. In particular ensure staff adhere consistently to practice protocols.
• Improve the practice's protocols for medicines management and ensure all medicines are stored and dispensed of safely and securely. Review the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
• Implement a system 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.