CQC tells Somerset practice to improve

CQC Inspectors found ADP Dental Company Bridgwater failed to comply with six essential standards. Ian Biggs, deputy director of CQC in the South said: “It is clear that ADP Dental Company Bridgwater has failed to ensure that its staff are properly trained to meet the standards required by law.   That is a particular concern in a practice which treats so many vulnerable people and relies so heavily on agency staff.

The Care Quality Commission (CQC) has told the ADP Dental Company Limited that it must take action to improve standards of care at one of its surgeries at Bridgwater in Somerset. In a report CQC inspectors identify concerns with six of the essential standards of quality and safety at the surgery The registered provider ADP Dental Company Ltd, based in Manchester, has been given 28 days to provide details of how it will comply with the standards. 

Inspectors visited the Bridgwater surgery in March as part of their routine schedule of planned reviews. CQC found that it was failing to meet government regulations on consent to care and treatment, care and welfare, infection control, safeguarding arrangements, safety and suitability of premises and support to staff. By law, providers of care services must ensure that they are meeting all standards.  

The report which has now been published on the CQC website gives further details:

Consent to care and treatment

Inspectors found that people's rights were not fully protected. Even though the practice treats a high number of vulnerable adults and children, some dentists did not appear to have a knowledge of the Mental Capacity Act, with the risk that decisions about treatment were not always made in people’s best interests.

Care and welfare of people who use services

Some members of staff did not feel confident and had not been trained to use specialist equipment provided in case of medical emergency. Inspectors found that people could not be assured that there were effective systems in place that reduced risks to their safety.

Safeguarding people

Some dentists and nurses knew how they would recognise signs of abuse, but most did not know what action they should take. People who used the service could not be certain that staff would take reasonable and appropriate steps to identify abuse and respond to it appropriately.

Cleanliness and infection control

While dental nurses were trained in decontamination and infection control procedures when they started, no one checked subsequently that they were competent. Nurses said that agency staff were not shown any infection control processes before they started. Inspectors found that patients were not protected from the risk of infection because relevant guidance and procedures set out by the Department of Health to prevent the spread of infections were not being followed.

Safety and suitability of premises

Inspectors found that people were not protected against the associated risks of some of the poorly maintained areas of the practice.

Support to staff

Dental nurses told the inspectors that they were not supported to complete their professional qualifications or to receive mandatory training. There was a high turnover of staff, with a lot of agency nurses, but with no induction procedures in place, there was a risk that patients might receive inappropriate or unsafe care.  

 

Ian Biggs continued: “One dentist told us they had worked with around 25 different dental nurses over the last year.  Some nurses had not received any mandatory training for some time including training in medical emergencies, infection control and safeguarding.

“Staff told us they had relied on the one qualified nurse at the practice for advice and guidance, which increased the pressure on this dental nurse's workload.  

“ADP have assured us that that they are now taking action to address these issues.  As a first step, they have been required to send CQC a report that shows how they are going to achieve compliance with these essential standards. 

"We will continue to monitor this service.  Our inspectors will return in the near future and if we find that this practice is not making progress we will consider using our legal powers on behalf of the people who use the service.”

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