We carried out an announced comprehensive inspection on 26 September 2016 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

The practice is located within a purpose adapted residential property in Billericay, Essex and offers private orthodontic treatments to adult patients and children.

The practice is open and offers appointments for patients between 9.30am and 5pm on Mondays to Fridays. Late evening appointments are available as required up to 7.30pm on Tuesdays, Wednesdays and Thursdays.

The practice employs four dentists and two dental nurses. The dental nurses cover reception duties.

The practice is registered with the Care Quality Commission (CQC) as an organisation. At the time of our inspection there was no registered manager. 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. Health and social care providers who are not registered as individuals are required to have a registered manager.

The practice has two treatment rooms, a combined waiting room and a reception area. Decontamination takes place in a dedicated decontamination room (Decontamination is the process by which dirty and contaminated instruments are bought from the treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

Our key findings were:

• The practice had systems in place for sharing relevant information, investigating and learning from complaints, safety incidents and accidents. Staff were aware of their responsibilities to report incidents.
• The practice was visibly clean and clutter free. Infection control practices were reviewed and audited to test their effectiveness.
• There were systems in place to help keep people safe, including safeguarding vulnerable children and adults.
• The practice had medicines and equipment for use in the event of a medical emergency were in line with current guidelines. Records were maintained in respect of the checks carried out for these medicines and equipment.
• Staff undertook training in respect of their roles and responsibilities within the practice.
• Patients reported that they were very satisfied with their treatment and that staff were respectful and helpful.
• Patients were provided with detailed information and treatment plans and were involved in making decisions about their care and treatments.
• The practice could normally arrange a routine appointment within a few days and appointments were flexible to meet the needs of patients.
• Effective governance arrangements were in place for the smooth running of the service.
• Audits and reviews were carried out to monitor and improve services,
• Patient’s views were sought and these were used to make improvements to the service where these were identified.

There were some areas where the provider could make improvements and should:

• Review the current arrangements for legionella risk management and carry out a risk assessment giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

• Submit an application to CQC for a relevant person to be registered as the manager for the service.

People told us they had been treated with respect and been made welcome at the surgery whenever they had attended for treatment. They informed us they had been provided with enough information about the types of treatment that had been available to them and that they were always encouraged to express their options about the course of treatment they preferred.

One person said that they were very happy with the service they had received. Another person had told us that they had had a very positive experience at this surgery.