We carried out a follow up inspection on 11 November 2016 of Polscy Lekarze Dental Service.

We had undertaken an announced comprehensive inspection of this service on 14 July 2015 as part of our regulatory functions and during this inspection we found breaches of the legal requirements.

After the comprehensive inspection, we asked the practice to provide us with an action plan to explain what they would do to meet the legal requirements in relation to the breaches. 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 three of the five questions we ask about services:

• Is it safe?
• Is it effective?
• Is it well-led?

We have not revisited Polscy Lekarze Dental Service as part of this review because the practice was able to demonstrate that they were meeting the requirements without the need for a visit.

A copy of the report from our last comprehensive inspection can be found by selecting the 'all reports' link for Polscy Lekarze Dental Service on our website at www.cqc.org.uk.

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

well-led

?

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

Background

The practice provides a range of dental treatments on a private basis. Approximately 95% of patients who use the service are Polish speaking. There is one dentist at the practice supported by a trainee dental nurse and the provider, who takes the role of receptionist and administrative support.

The practice offers appointments between 9.30am and 9pm every weekday and offers an emergency service at weekends. The practice owner, dentist and trainee nurse attend the practice when an appointment is booked, providing a ‘drop in’ service.

The dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Our key findings were:

• Audits were carried out every six months to assess the risks of cross infection in line with HTM 01 05 (national guidance for infection prevention and control in dental practices) Essential Quality Requirements for infection control.
• Staff received training in basic life support; and an automated external defibrillator (AED) was available in the practice.
• Dental care records contained details of all examinations undertaken.
• Medical history questionnaires included a section for patients to disclose any medicines taken.

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

• Ensure a Legionella risk assessment is carried out by a competent person.
• Include in their clinical record keeping audit a section to reflect that oral health advice offered to patients is recorded in patients’ dental care records.

We carried out an announced comprehensive inspection on 14 July 2015 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

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

Are services effective?

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

This is the first inspection of Polscy Lekarze Dental Service which was registered with the CQC in September 2013. The practice provides a range of dental treatments on a private basis. Patients can register with the practice from anywhere in the country. Approximately 95% of patients who use the service are Polish speaking. There is one dentist at the practice supported by a dental nurse in training and the provider who takes the role of receptionist and administrative support. The practice offers appointments between 9.30am and 9pm every weekday and offers an emergency service at weekends. Appointments are available by calling the practice telephone number. The dentist, provider and nurse attend the practice when an appointment is booked but are not on site at all times providing a ‘drop in’ service.

The dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Our key findings were:

• The practice provided flexible access to appointments and was available between 9.30am and 9pm every weekday.

• The practice was clean and tidy and instruments were cleaned and decontaminated in accordance with current guidance.

• The small practice team of three worked closely together to offer a personalised and flexible service to their patients.

• Patients received both a detailed verbal description and a written treatment plan when a course of treatment was proposed.

• The systems in place for reviewing health and safety had not identified that control of infection audits had not been completed.

• The practice had not followed General Dental Council requirements because they did not hold all emergency equipment required.

We identified regulations that were not being met and the provider must:

• Ensure audits to assess the risks of cross infection are carried out every six months in accordance with current guidance.

• Ensure all staff, including the provider, are trained in basic life support and that immediate access to an Automated External Defibrillator (AED) is available.

• Ensure dental records include details of all examinations undertaken and advice given in respect of care and treatment.

• Ensure prescribed medication taken by patients is included in their medical history record.

You can see full details of the regulations not being met at the end of this report.

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

• Undertake a written legionella risk assessment.