Updated 10 December 2021
We carried out this announced focused inspection on 9 November 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
West Hill Dental Care is near Ottery St Mary and provides NHS dental care and treatment for adults and children. A small amount of private dental care is also provided.
The treatment room is on the ground floor and there is level access to the rear for wheelchair users. Car parking is on the quiet main road adjacent to the practice.
The dental team includes one dentist, two dental nurses and one receptionist. The practice has one treatment room.
The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
During the inspection we spoke with the provider/dentist, one dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open: Five days a week, with clinics conducted on three days a week.
Our key findings were:
- The practice appeared to be visibly clean and well-maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines were available. Some life-saving equipment was out of date.
- Improvements could be made regarding effective systems to help manage risk to patients and staff.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The provider had staff recruitment procedures which reflected current legislation.
- Record keeping was not sufficiently robust to consistently demonstrate that care and treatment was performed in line with current guidelines.
- Staff treated patients with dignity and respect.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- There were ineffective governance arrangements to ensure 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 staff team told us they had received no complaints since the last inspection.
- The policy for Information Governance and social media use would benefit from updating.
We identified a regulation 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.
Full details of the regulation the provider is not meeting are at the end of this report.
There were areas where the provider could make improvements. They should:
- Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice/College of General Dentistry.
- Take action to ensure the clinicians take into account the record keeping guidance provided by the Faculty of General Dental Practice/College of General Dentistry when completing dental care records.
- Improve the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term.