CQC orders enforcement action at Wollaston Dental clinic

A WOLLASTON dental clinic boss has spoken out after coming under fire from a healthcare watchdog over safety regulations.

The latest report by the Care Quality Commission reveals enforcement action has been ordered at Wollaston Dental following an inspection on July 25.

Dr Kenneth Moylan, who runs the practice, however, said much of the criticism related to paperwork.

The report, published on August 24, says the High Street practice was not fully complying with regulations that help to ensure services are safe, effective and well-led.

It said the dental care provider must take action to ensure treatment is provided safely and to establish effective systems to ensure good governance in accordance with the fundamental standards of care.

The report said the registered person at the practice had “not done all that was reasonably practicable to mitigate risks to the health and safety of service users receiving care and treatment” and, in particular, treatment using conscious sedation was not provided in line with current guidance.

According to the report, inspectors found patients’ sedation needs were not assessed and recorded and written consent for procedures carried out under conscious sedation was not obtained prior to the day of treatment.

It said pre-operative vital signs were not recorded prior to delivery of sedative drug midazolam and there was no record in dental care records of the volume or concentration of the drug given to patients.

The report added that contemporaneous patient notes were not recorded (including vital signs of the patient) during the conscious sedation procedure and post-operative instructions for the patient and details of the patient’s escort were not recorded.

A logbook of conscious sedation cases was also not maintained and not all staff involved in the process had appropriate training.

An audit relating to the provision of conscious sedation had also not been completed.

The report said systems operated “ineffectively” and failed to assess, monitor and improve the quality and safety of services.

It acknowledged efforts were being made to demonstrate improvements over time but said policies and procedures, especially relating to conscious sedation, were yet to be embedded.

A CQC spokesperson said: “The practice did not have systems to ensure the safe provision of conscious sedation. This included checks before, during and after treatment, availability of emergency equipment, medicines management, sedation equipment checks, staff availability and training.”

Although the CQC has not suspended any activities at the practice, the spokesperson added: “The provider assured us that dental care or treatment using conscious sedation would not be undertaken until these systems were in place.”

Practice boss Dr Moylan said: “Whilst the CQC report looks quite damning it’s important to look a little deeper.”

Of the issues regarding conscious sedation, he said: “If I follow all the clinical guidelines, which I do, monitor blood pressure and oxygen saturation., titrate the amount of drug given, check the patient is safe to discharge and discharge into the care of their escort then this is considered safe if all the readings are written down.

“If they are not written down its considered unsafe. I accept the criticism and now comply with the latest guidelines…notes, notes and more notes. “Governance in the dental surgery is now a very big topic.

“Can you believe the CQC asked me what my policy was on female genital mutilation? I didn’t have one but do now.”


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