We undertook a focused inspection of Preston Circus Dental Practice on 17 January 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector.

We undertook a comprehensive inspection of Preston Circus Dental Practice on 3 July 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well led care and was in breach of regulations 12 Safe care and treatment and 17 Good governance, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Preston Circus Dental Practice dental practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it safe?

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area’s where improvement was required.

Our findings were:

Are services safe?

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

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 3 July 2018.

Are services well-led?

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

The provider had made improvements in relation to the regulatory breach/es we found at our inspection on 3 July 2018.

Background

Preston Circus Dental Practice is in Brighton and provides NHS and private treatment for adults and children.

There is no level access for people who use wheelchairs and those with pushchairs as the practice is accessed via a flight of stairs. Car parking spaces, including some for blue badge holders, are available near the practice.

The dental team includes three dentists, two dental nurses, one student nurse, one dental hygienist, two receptionists and the practice manager. The practice has three treatment rooms.

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 one dentist, one dental nurse and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 9am to 5pm

Our key findings were:

• Staff had implemented good infection control processes and procedures that reflected current guidance.
• The practice had implemented good risk management throughout the practice and risk assessments in relation to legionella, safe sharps and maintenance of the property had been conducted.
• The practice had implemented a recognised clinical governance programme
• The provider had made many improvements and renovations to the practice
• The practice had conducted audits in the quality of x-rays , dental records and infection control. Gaps had been identified and were being addressed.

We carried out this unannounced inspection on 3 July 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.

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 not 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

Preston Circus Dental Practice is in Brighton and provides NHS and private treatment to adults and children.

There is no level access for people who use wheelchairs and those with pushchairs as the practice is accessed vis a flight of steps. Car parking spaces, including some for blue badge holders, are available near the practice.

The dental team includes three dentists, 1 dental nurse, 1 student nurse,1 dental hygienist, and 1 receptionist and the practice manager. The practice has four treatment rooms.

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.

On the day of inspection we did not collect CQC comment cards as this inspection was unannounced. We spoke with two patients prior to our inspection.

During the inspection we spoke with two dentists, two dental nurses, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 9am to 5pm

Our key findings were:

• The practice staff appeared clean and well maintained.
• The practice staff did not have sufficient infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice did not have sufficient systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures.
• 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff did not have suitable information governance arrangements.

We identified regulations the provider was not meeting. They must:

• Ensure care and treatment is provided in a safe way to patients
• Ensure all premises and equipment used by the service provider is fit for use
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

Full details of the regulation/s the provider was/is not meeting are at the end of this report.

When we previously inspected The Preston Circus Dental Practice we found that the provider was not meeting all the requirements of the Health and Social Care Act 2008.

During this inspection we spoke with three members of staff, these were two dental nurses and a dentist.

The improvements required to comply with the regulations, in relation to having an effective accident and incident recording system were in place and had been made.

During our inspection we spoke with six patients. We spoke with three members of staff; these were the dental nurse / receptionist and two dentists.

We also took information from other sources to help us understand the views of people who used the service, which included a patient satisfaction survey and staff meeting minutes.

The patients we spoke with told us they thought they had received good dental treatment from the dentists. One patient told us “I’m more than happy with the care I get”. Another patient told us “The dentist I see is lovely, they see my whole family”.

The practice was following appropriate guidance in relation to infection control and we also saw that the service had quality assurance systems in place to monitor the quality of the service provided. However we did identify non-compliance with respect to the recording and analysis of accidents and incidents.