We carried out this announced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations.

A CQC inspector, who was supported by two specialist dental advisers, led the inspection.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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 well-led care in accordance with the relevant regulations.

Background

Brampton Dental Practice is a well-established practice that provides private treatment to patients of all ages. The dental team consists of three dentists, two hygienists, five dental nurses, a decontamination assistant, two receptionists and a practice manager. The practice has three treatment rooms and is open on Mondays from 9am to 4.30pm; Tuesdays from 9am to 8pm; Wednesdays 8.30am to 4pm; Thursdays from 9am to 8pm and Fridays from 9am to 5pm.

There is ramp entry access for people who use wheelchairs.

The practice is owned by a company and, as a condition of registration, must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Brampton Dental Practice is the principal dentist.

During the inspection we spoke with two dentists, the practice manager, two dental nurses and reception staff. We looked at the practice’s policies and procedures, and other records about how the service is managed. We also collected 50 comment cards filled in by patients:

Our key findings were:

• We received many positive comments from patients about the dental care they received and the staff who delivered it.

• The practice had systems to help ensure patient safety. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control, and responding to medical emergencies.

• The practice offered extended hours opening two evenings a week to meet the needs of its patients commuting to London for work.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• Members of the dental team were up-to-date with their continuing professional development and supported to meet the requirements of their professional registration.

• There was a clear leadership structure and staff felt supported and valued by the practice manager and principal dentist. Teamwork in the practice was good.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, issued from the Medicines and Healthcare products Regulatory Agency (MHRA).

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result

• Review the practices’ current Legionella risk assessment and implement the required actions taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’

• Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.

During our visit to the practice on 26 January 2012 we spoke to six people who use the service. They each told us that the staff team were always polite and friendly and welcomed them to the surgery. One person said, "My dentist is excellent, they treat me as an equal and always explain the choices and options that I can make about my treatment”. Another person said, "All the staff here are always polite and respectful to me. They make me feel welcome and at ease".

We received positive comments from each of the six people about how they had been consulted about their course of treatment and had been given clear information about the choices they could make and that they had chosen their preferred type of treatment. One person told us that they had been given an introductory package containing information about the practice when they had first attended the surgery. Another person made a negative comment in a survey carried out by the practice in October 2011 and had answered: "Staff seem able to walk through the room where I am having treatment to get to another room".