Howard Stean - Mortlake Road Kew

We carried out this announced focused inspection on 01 July 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.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• Staff felt involved and supported and worked as a team.
• The dental clinic had information governance arrangements.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. However, not all staff had undertaken appropriate training.
• The practice had infection control procedures which largely reflected published guidance.
• Staff knew how to deal with medical emergencies although further training was needed. Not all medicines and life-saving equipment were available.
• The practice had staff recruitment procedures which reflected current legislation; however, staff records were incomplete.
• The practice had some systems to help them manage risk to patients and staff; however, these were not documented effectively.
• There were systems to support continuous improvement, but these could be reinforced.
• There were ineffective systems to ensure that staff were up to date with their training.
• Risks to staff and patients from undertaking regulated activities had not been suitably identified and mitigated.

Background

Howard Stean - Mortlake Road Kew is in Richmond-upon-Thames and provides private dental care and treatment for a small selection of long-standing adult patients

There is level access to the practice for people who use wheelchairs and those with pushchairs. Dedicated car parking spaces, including some for disabled people, are available in the neighbouring retail park near the practice.

The dental team includes one dentist and one dental nurse. The practice has one treatment room.

During the inspection we spoke with the principal dentist and the dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday to Thursday

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.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties

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