Advanced Dental Aesthetics

We carried out this announced comprehensive inspection on 30 January 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 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.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available. Improvements were required to ensure emergency medicines were stored in accordance with the manufacturer’s instructions
• Improvements were required to the practice systems to manage risks for patients, staff, equipment and the premises.
• 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.
• 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.
• 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.
• Improvements were needed so clinical staff were aware of current guidelines such as guidance in relation to antibiotic prescribing and the management of periodontal disease.
• There was ineffective leadership and the practice lacked a culture of continuous improvement.

Background

Advanced Dental Aesthetics is in Southend on Sea and provides NHS and private dental care and treatment for adults and children.

There is step free 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 dental team includes 5 dentists, 6 dental nurses and 2 dental hygienists. The clinical team are supported by a receptionist. The practice has 3 treatment rooms.

During the inspection we spoke with 3 dentists, 2 dental nurses, the practice manager and the receptionist. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open between:

9am and 5pm Mondays to Thursdays

9am and 4pm on Fridays

9am and 2pm on Saturdays

We identified regulations the provider was/is not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

Full details of the regulation the provider was not meeting are at the end of this report.

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

• Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account HPA-CRCE-010 Guidance on the Safe Use of Dental Cone Beam (Computed Tomography).
• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
• 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.