We carried out an announced comprehensive inspection on 16 July 2015 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?
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
Kingston Dental Clinic is located in Kingston town centre. The premises consist of one treatment room, a dedicated decontamination room, waiting room, reception area and toilet. It is on the first floor only accessible by a staircase.
The practice provides private dental services and treats both adults and children. The practice offers a range of dental services including general and cosmetic dentistry.
There was one dentist, a part time dental nurse and a part time trainee dental nurse. The dentist and the trainee dental nurse were available on the day of inspection.
The practice is open Monday and Wednesday from 9.00am to 6.00pm and on Saturday from 11.00am to 4.00pm by appointment.
This practice was first registered with the Care Quality Commission (CQC) in April 2013. It has not previously been inspected.
Nine people provided feedback about the service. Patients we spoke with on the day of inspection, and those who completed CQC comment cards, were positive about the care and treatment they received from the practice.
Our key findings were:
- Patients’ needs were assessed and care was planned in line with national guidance such as from the National Institute for Health and Care Excellence.
- Equipment, including the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
- Staff had received safeguarding and whistle blowing training and knew the procedures to follow to raise any concerns.
- Patients indicated that they were given information and time to decide on treatment options and felt listened to.
- The practice ensured staff attended relevant training to maintain the necessary skills and competence to meet patients needs.
- The practice had developed a clear complaints process that was accessible to patients at the practice and in the patient information leaflet.
- The dentist had a clear vision for the practice which staff understood.
- Patients were treated with dignity and respect and confidentiality was maintained.
- Risks to patients and staff had not been always been suitably assessed and mitigated.
We identified regulations that were not being met and the provider must:
- Review governance arrangements including the effective use of risk assessments, and audits, such as those for infection control and X-rays.
- Establish an effective system to assess, monitor and mitigate the risks including and not limited to those associated with cleaning of used dental instruments.
You can see full details of the regulations not being met at the end of this report.
There were areas where the provider could make improvements and should:
- Review its protocols regarding receipt of Medicines and Healthcare products Regulatory Agency (MHRA) alerts to ensure they are received and acted upon in a timely way.
- Undertake regular checks to ensure emergency medicines, oxygen cylinder and equipment are within their expiry date.
- Revise the practice's recruitment arrangements so they are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.
- Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
- Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.