We carried out an announced comprehensive inspection on 31 January 2017 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 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 providing well-led care in accordance with the relevant regulations

Background

Barbara Castle Dental Practice in Harlow Essex provides NHS and private dental treatment to patients of all ages.

Practice staffing consists of a principal dentist, two associate dentists, one hygienist, two dental nurses, one receptionist and a practice manager.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

The practice is open Monday to Friday 9am to 5pm and every other Saturday 1.30 to 5pm

The practice facilities include two treatment rooms, reception/ waiting area, decontamination room, and a staff kitchen.

31 patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received about the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• There were systems in place to ensure that all equipment was maintained in line with manufacturer’s guidelines.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• The practice ensured staff were trained and that they maintained the necessary skills and competence to support the needs of patients.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical audits were carried out to monitor the quality of services.
• The practice sought feedback from patients about the services they provided and acted on this to improve its services.

During our last inspection on 28 February 2013, we found shortfalls in the way that some aspects of the control of infection was managed. We also found that the provider was not regularly assessing the quality of the service that was provided.

We issued compliance actions and asked the provider for an action plan setting out how they would meet these standards.

During our inspection on 15 August 2013 we found improvements, surrounding infection control and the monitoring of the quality of service.

We did not speak to any people who used the service during our inspection.

We spoke with three people who used the service. They confirmed that their dentist gave them information on the treatment that they needed and the options available to them. One person told us, " [The dentist] is fantastic and explains everything." They told us that it had been easy for them to make an appointment at a time that suited them. Another person told us, "I'm quite happy with what they [the dentist] have done." One person said that staff members were, "Very nice."

The care and treatment records showed the medical history was checked at each consultation before treatment was started.

We noted that the practice premises were small, cramped and somewhat untidy. We spoke with one of the dental nurses who told us that the dental nurse assigned to each treatment room was responsible for cleaning it. There were no records of any audit of decontamination processes.

We looked at the 'Vital Signs at a Glance Contract Report' for the quarter to September 2012. This showed that all the respondents in respect of the practice had been satisfied with the dentistry they had received and with the time they had to wait for an appointment to be made. However, this report related only to responses from a small number of people who received treatment on the NHS. There was no record that people who received private treatment were asked for their views on the quality of the service that they received.