We carried out an announced comprehensive inspection on 8 November 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

Oasis Dental Care Southern – Banstead is a dental practice that is a part of Oasis Dental Care (Southern) Limited. Oasis Dental Care Limited is a large corporate provider of dental services across England. The practice Oasis Dental Care – Woking is a mixed NHS and private general dental practice. The premises are located on a main road next to a row of residential property on one side and a commercial building on the other. The practice has a car park available at the front of the property for disabled patients and a rear car park for more mobile patients and staff. The practice has two levels. The ground level has the reception area, an office, a waiting area, four treatment rooms, a decontamination room and a patient toilet. The first floor level has a further three treatment rooms, a decontamination room and an X-ray room.

The practice staffing consisted of a practice manager, seven dentists, five dental hygienists, six dental nurses (including one trainee), and four reception/admin staff. There is a larger support network that is located at headquarters in Bristol that provides support as part of the wider corporate management structure.

The practice opening hours are Monday to Thursday from 8.00am to 7.00pm, Friday from 8:00am to 6:00pm and Saturday 8:30am to 12:30pm.

The practice manager was recruited one month before the date of this inspection. They were in the process of applying to become the registered manager. [BSB1]A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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.

We reviewed 20 Care Quality Commission (CQC) comment cards that had been completed by patients in the two weeks prior to our inspection. Common themes were patients felt they received excellent care from friendly staff who were professional, caring and understanding. They also commented positively about the dentists making nervous patients feel relaxed.

Our key findings were:

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers and the X-ray equipment.

• We found the dentist regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.
• There was an induction programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• Patients received clear explanations about their proposed treatment, and its costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.
• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.
• At our visit we observed staff were kind, caring and welcoming.

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

• Consider providing an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the supply of antibiotics for patients in line with current secondary prescribing guidelines published by the British Pharmaceutical Society.

We found that the practice respected and involved persons using the service in decisions about their care.

Following our inspection we spoke by telephone with four people who use the service. One person said, "I have been using the dentist there for over 35 years, even though I moved away from the area 20 years ago. That's how good I think they are."

Another told us "Even though I have only had fillings, I was given a choice in the type of filling to have and was able to discuss this with my dentist." The same person told us "I am very impressed with the practice."

We were told by a person we spoke with the staff were "Very friendly. I have known them for years and they have always treated me with respect."

During our inspection we found people's care and welfare was considered by the service and policies in place protected people who used the service from harm or abuse. One person we spoke with said "I have always felt safe while at the practice."

We also found the service monitored the quality of the service provided through feedback and surveys, and had used the results to improve the service they provided. One person told us "There is a questionnaire in the waiting room and I have written a letter of praise following treatment."

The service was provided in a clean and hygienic environment, we found, however, that the needs of people using the service and staff were not being fully met due to the absence of a registered manager at the service.