We carried out this announced focused inspection on 1 June 2021 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 asked the following three questions:
• 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:
Are services safe?
We found this practice was 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 well-led?
We found this practice was not providing well-led care in accordance with the relevant regulations.
Background
Night and Day Emergency Dentist is in Withington, Manchester and provides only emergency and urgent 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. On street parking is available near the practice.
The dental team includes five dentists, two dental nurses (one of whom manages the practice), and a receptionist. The practice has two treatment rooms.
The practice is owned by a company 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 Night and Day Emergency Dentist is the principal dentist.
During the inspection we spoke with the principal dentist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
The practice offers a private 24-hour telephone dental triage and advice service.
Core hours are from 9am until 5pm but this extends into the evening according to demand.
Our key findings were:
- The practice appeared to be visibly clean, tidy and well-maintained.
- The provider had infection control procedures which reflected published guidance.
- The provider had implemented standard operating procedures in line with national guidance on COVID-19.
- We were not assured that staff completed up to date training to deal with medical emergencies. Appropriate medicines were available, but life-saving equipment was not in line with Resuscitation Council UK guidance. This was addressed immediately.
- The systems to help them identify and manage risk to patients and staff were ineffective.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- Staff recruitment procedures did not reflect 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.
- The provider did not have effective leadership in place.
- The provider asked staff and patients for feedback about the services they provided.
- The provider did not maintain oversight of staff training. Training certificates were not obtained for all staff.
We identified regulations the provider was not complying with. They must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
Full details of the regulations the provider is not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Take action to ensure staff have received training in the recognition, diagnosis and early management of sepsis in line with National Institute for Health and Care Excellence guidance.