We carried out an announced comprehensive inspection on 09 February 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

Bounds Green Dental Practice is located in the London Borough of Haringey. The practice provides NHS and private dental treatment to both adults and children. The premises are on the ground floor and consist of three treatment rooms, an X-ray room, a reception area and a decontamination room. The practice is open Monday – Tuesday 8:30am – 4:00pm and Wednesday - Friday 9:00am – 5:00pm.

The staff consists of three associate dentists, a dental hygienist, two dental nurses, a trainee dental nurse, two receptionists and a practice manager.

The practice manager is registered with the Care Quality Commission (CQC) as an individual ‘registered person’. 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.

We reviewed 24 CQC comment cards and the NHS Friends and Family test. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Our key findings were:

• There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection.
• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients indicated that they found the team to be efficient, professional, caring and reassuring.
• Patients had good access to appointments, including emergency appointments, which were available on the same day.
• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.

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

• Review the storage of records related to people employed and the management of regulated activities giving due regard to current legislation and guidance.
• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting.
• Review the practice’s safeguarding policy ensuring it covers both children and adults and all staff are trained to an appropriate level for their role and aware of their responsibilities.

People using the clinic were very positive about the service, and told us that their treatment options and costs were explained to them and their privacy and dignity were respected. They were able to book appointments at times convenient to them, and were seen promptly by dental staff when they arrived at the practice.

The clinic environment was clean with clear processes in place to maintain the hygiene of treatment rooms and instruments between each patient.

Appropriate records were kept of each appointment including initial assessments and medical histories.

Appropriate pre-employment checks were carried out on staff with relevant training in place addressing medical emergencies, health and safety and infection control.

The practice carried out regular audits and monitored the quality of service provided to patients.