We carried out this announced inspection on 10 February 2020 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 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 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 this practice was not providing safe care in accordance with the relevant regulations.
Are services effective?
We found this practice was providing effective care in accordance with the relevant regulations.
Are services caring?
We found this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found this practice was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found this practice was not providing well-led care in accordance with the relevant regulations.
Background
The Broadway Dental Practice is in Catford in the London Borough of Lewisham and provides NHS and private dental care and treatment for adults and children.
There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice for a fee. Local transport services are available nearby.
The dental team includes two principal dentists, two associate dentists, two dental nurses, a trainee dental nurse and a practice manager (who is also a qualified dental nurse and can provide nursing cover). Reception duties are covered by the practice manager and the dental nurses. The practice has two treatment rooms.
The practice is owned by a partnership and as a condition of registration must have a person registered with the CQC 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 The Broadway Dental Practice is the one of the principal dentists.
On the day of inspection, we collected 37 CQC comment cards filled in by patients.
During the inspection we spoke with one of the principal dentists, one of the associate dentists, both of the dental nurses, the trainee dental nurse and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
9.00 – 6.00pm Monday, Tuesday, Wednesday and Friday
9.00 - 8.00pm Thursday
9.00 -1.00pm Saturdays (one Saturday a month).
Our key findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had staff recruitment procedures which reflected current legislation.
- 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 supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. Improvements were required with regards to the provider having an oversight of staff’s training.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. Improvements were required with regards to carrying out regular checks to ensure medicines were within their use by date and ensuring availability of medical oxygen and equipment.
- Improvements were required to the systems that helped the provider manage risk to patients and staff.
- Improvements were required to the information governance arrangements.
- Improvements were required with regards to following infection control procedures published guidance.
We identified regulations the provider was not complying with. They must:
- Ensure care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
Full details of the regulations the provider was not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Take action to ensure all clinicians take into account the guidance provided by the Faculty of General Dental Practice when completing dental care records.