Updated 28 April 2022
We carried out this announced focused inspection on 29 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 effective?
• Is it well-led?
These questions form the framework for the areas we look at during the inspection.
Our findings were:
- The dental clinic was visibly clean and well-maintained.
- The practice had infection control procedures which did not always reflected published guidance. Decontamination and storage of dental instruments did not always follow HTM 01-05.
- Staff knew how to deal with medical emergencies. At the time of our inspection not all appropriate medicines and life-saving equipment were available.
- Systems to help manage risk to patients and staff from legionella were not robust or effective.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice staff recruitment procedures did not reflect current legislation. Required pre employment information was not available for all staff.
- Clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff provided preventive care and supported patients to ensure better oral health.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- The dental clinic had information governance arrangements.
The provider took swift action to address the concerns identified.
Background
The provider has two practices and this report is about West Road Dental.
West Road Dental is in Oakham and provides NHS and private general 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, including dedicated parking for disabled people, are available near the practice. The practice has made some adjustments to support patients with additional needs. Including the use of a hearing loop and access to interpreter services.
The dental team includes five dentists, four dental nurses, of whom two are trainees, one dental hygienist, two dental therapists, a practice manager and one receptionist. The practice has three treatment rooms.
During the inspection we spoke with one dentist, two dental nurses, one dental hygienist, 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 Friday from 8.30am to 5pm
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 that, where required, instruments are stored in sterile pouches, trays used for storing instruments are able to be cleaned and sterilised, single use items are cleaned and prepared for reuse. Instruments awaiting cleaning are stored appropriately.
- Take action to implement any recommendations in the practice's Legionella risk assessment, 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 that staff completing risk assessments have received appropriate training. Cold water sentinel tap temperature checks are recorded. Staff completing risk management processes are aware of which areas and outlets should be checked.
- Implement an effective recruitment procedure to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.
- 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.