Hurst Farm Dental Practice

We carried out this announced inspection on 25 November 2021under 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 always ask 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 providing well-led care in accordance with the relevant regulations.

Background

Hurst Farm Dental Practice is in Godalming and provides NHS and private dental care and treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice.

The dental team includes three dentists, a dental nurse, a trainee dental nurse, a dental hygienist and three receptionists. 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 two dentists, two dental nurses, a dental hygienist and a receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday 9am to 5.30pm
• Tuesday 9am to 5.30pm
• Wednesday 9am to 5.30pm
• Thursday 9am to 5.30pm
• Friday 9am to 5.30pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance, except for the disinfection process of dental appliances returned from the dental laboratory.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available, except for an automated external defibrillator (AED).
• The provider had systems to help them manage risk to patients and staff. However, improvements should be made to the Control of Substances Hazardous to Health file.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The dental care records we looked at could be improved in relation to information recorded.
• The provider had staff recruitment procedures which reflected current legislation.
• 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.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and 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 provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements.

There were areas where the provider could make improvements. They should:

• Take action to ensure an automated external defibrillator (AED) is available immediately to manage medical emergencies, taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council, and undertake a risk assessment if a decision is made not to have an AED on site.

• Improve the practice's processes for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.

• Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.

• Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ In particular the disinfection of dental appliances prior to use.