We carried out a follow-up inspection at Poldent Dental Care on 12 February 2018.

We had undertaken an announced comprehensive inspection of this service on the 1 and 11 December 2017 as part of our regulatory functions where a breach of legal requirements was found.

After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breach. This report only covers our findings in relation to those requirements. We checked whether they had followed their action plan to confirm that they now met the legal requirements.

We reviewed the practice against one of the five questions we ask about services: are the services well led? You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Poldent Dental Care on our website at www.cqc.org.uk.

We revisited Poldent Dental Care as part of this review and checked whether they now met the legal requirements. We carried out this announced inspection on 12 February 2018 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 CQC inspector who was supported by a specialist dental adviser.

• Is it well-led?

This question forms the framework for the areas we look at during the inspection.

Our findings were:

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Poldent Dental Care is in Wakefield and provides private dental treatment to adults and children. They also provide ultrasound scans for pregnant women. Services are provided primarily to Polish patients who reside in the United Kingdom (UK).

Car parking spaces are available near the practice.

The practice is not accessible for wheelchair users.

The team includes four dentists, one consultant gynaecologist, one trainee dental nurse, one dental hygienist (who also works as a dental nurse when required), an assistant practice manager and a practice manager. The practice has two dental treatment rooms and a room for medical treatments.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Poldent Dental Care was the practice manager.

During the inspection we spoke with one dentist, the trainee dental nurse, the assistant manager, the practice manager and the company secretary. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday from 9:30am to 5:30pm

Tuesday to Thursday from 1:00pm to 9:00pm

Friday from 9:30am to 9:00pm (times may vary)

Saturday from 9:00am to 5:00pm

Sunday from 8:00am to 5:00pm

Our key findings were:

• Staff had completed infection prevention and control training. Improvements had been made to the processes for checking decontamination equipment.
• Staff had completed hands on medical emergency training. Appropriate medicines and life-saving equipment were available.
• A sharps risk assessment had been carried out. The outstanding actions from the fire risk assessment had been carried out.
• A system was in place for referring patients to their GP or hospital in the event of an abnormal ultrasound scan.
• Policies had been updated and the governance system was effective.
• Audits of infection prevention and control and radiographs had been completed.

We spoke with one person who used the service and comments included:

“I’m really happy with them, ten out of ten.”

"If someone has a problem with teeth I'd recommend this place."

We noted that the was clean and tidy; however there were some infection control issues with the surgery located on the first floor.

We saw that the practice actively sought patient feedback and had made changes as a result of feedback. For example the opening hours had been extended to offer evening and weekend appointments.

We were unable to speak directly to people who use the service as part of this inspection visit.

We carried out this announced inspection on 1 and 11 December 2017 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 inspections were led by a CQC inspector who was supported by a second GP inspector and a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five 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:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was not providing well-led care in accordance with the relevant regulations.

Background

Poldent Dental Care is in Wakefield and provides private dental treatment to adults and children. They also provide gynaecological services. Services are provided primarily to Polish patients who reside in the United Kingdom (UK).

Car parking spaces are available near the practice.

The practice is not accessible for wheelchair users.

The team includes four dentists, one consultant gynaecologist, one trainee dental nurse, one dental hygienist (who also works as a dental nurse when required), an assistant practice manager and a practice manager. The practice has two dental treatment rooms and a room for medical treatments.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Poldent Dental Care was the practice manager.

On the day of inspection we collected five CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, the trainee dental nurse, the assistant manager, the practice manager and the company secretary. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday from 9:30am to 5:30pm

Tuesday to Thursday from 1:00pm to 9:00pm

Friday from 9:30am to 9:00pm (times may vary)

Saturday from 9:00am to 5:00pm

Sunday from 8:00am to 5:00pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had suitable infection control procedures. Improvements could be made to some processes surrounding testing the equipment involved in decontamination.
• The practice did not have access to an automated external defibrillator (AED) and some emergency equipment and medicines were not in line with recognised guidance. We were later sent evidence that an AED had been ordered and the missing medicines and equipment had been ordered.
• Staff had not completed hands on medical emergency and life support training since November 2014.
• Risk was not being effectively managed. For example, the risks associated with fire and sharps.
• There was not an effective system in place to refer patients with abnormal cervical screening test results back to their GP.
• The practice had safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• Dental care records lacked detail especially with regards to consent.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• Governance procedures were not all effective, for example, the practice did not have a recruitment policy or effective recruitment procedures.
• The practice asked patients for feedback about the services they provided.
• The practice had a complaints policy in place. We noted that complaints were not always thoroughly documented.

We identified regulations that were not being met and the provider 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.

There were areas where the provider could make improvements and should:

• Review the practice’s infection control procedures and protocols taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and a report of the X-ray in compliance with the Ionising Radiation (Medical Exposure) Regulations 2000.
• Review the practice's protocols for completion of dental records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.