We carried out an announced comprehensive inspection on 27 July 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

Cat Hill Dental Practice is located in the London Borough of Barnet and provides mainly private treatment to both adults and children. The premises are on the ground and first floor and consist of three treatment rooms, a reception area and a dedicated decontamination room. The practice is open Monday to Wednesday 8:45am – 6:00pm, alternate Wednesdays 8:45am – 7:30pm, Thursday to Friday 8:45am – 5:00pm and one Saturday per month 9:00am – 1:00pm.

The staff consists of the principal dentist, two dental hygienists, two dental nurses, a practice manager and a receptionist.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual ‘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 40 CQC comment cards and the practice patient satisfaction survey. 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:

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

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 practice’s protocols for medicines management and ensure all medicines are stored safely and securely.
• Review the practice’s infection control procedures and protocols giving due regard to 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’.
• Review the current Legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, 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’.
• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.
• Review the practice’s audit protocols to ensure audits of various aspects of the service, such as radiography and dental care records are undertaken at regular intervals to help improve the quality of service. Practice should also check that where applicable audits have documented learning points and the resulting improvements can be demonstrated
• Review its complaint handling procedures and establish an accessible system for identifying, receiving, recording, handling and responding to complaints by patients.

We were able to speak to patients of the dental practice. They indicated that they had been treated with respect and dignity. They expressed satisfaction with the care and treatment provided. The practice has a policy for ensuring that all patients are treated with respect and dignity.

Patients made positive comments about staff and indicated that they felt safe and had confidence in the dentist and other staff who attended to them. Detailed assessments and treatment plans had been prepared for patients. Treatment had been given with patients’ agreement and written consent.

The premises were clean and well maintained. There were arrangements for infection control checks and daily cleaning tasks. Staff were knowledgeable regarding infection control and decontamination procedures for equipment and instruments used. There was documented evidence that equipment used had been maintained and inspected by specialist contractors.

Patient records were being updated after each patient was seen by the dentist to ensure these records were accurate and fit for purpose.