We carried out this announced inspection on 7 August 2018 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. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

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 providing well-led care in accordance with the relevant regulations.

Background

Caterham Dental Centre is in Caterham and provides NHS and private treatment to adults and children.

The practice is on the 1st floor with a lift access for people who use wheelchairs and those with pushchairs. Car parking spaces, are available near the practice.

The dental team includes 3 dentists, 3 dental nurses, 3 dental hygienists, 2 trainee dental nurses and 2 receptionists. The practice has 4 treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 21 CQC comment cards filled in by patients and spoke with 2 other patients.

During the inspection we spoke with 2 dentists, 2 dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: from 09.00-13.00 14.00-17.00 Monday to Friday

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
• Review the practice's protocols for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
• Review the practice’s protocols for recording in the patients’ dental care records.
• Review staff training to ensure that all the staff have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.
• Review staff training to ensure that all the staff have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.
• Review the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term.

As part of our inspection we spoke with four patients. Patients spoke positively about the staff and practice. One patient said "We all come here {the family}, everyone is so nice and even the children like coming."

One person we spoke with told us “The dentists and the nurses here are always very clear about what is happening. They explain things to me whilst I’m here and then give information to me in writing”. This meant that patients were involved in identifying their care, treatment and support options with alternatives, risks and benefits clearly explained.

We saw documents which confirmed all professionally practicing staff at the practice held relevant current registrations with the General Dental Council (GDC). We also saw documents which confirmed that the provider held checks with the disclosure and barring service (DBS) for all staff. These checks ensure that only people who are suitable to work with vulnerable adults and children are employed by the service.

Staff we spoke with were able to describe good infection control and hygiene practices before, during and after a consultation. One patient we spoke with told us "It’s always spotless. I’ve never had any concerns about how clean the practice was".

We saw the service followed good quality assurance procedures. We found that regular audits had been completed to include decontamination and sterilisation, pressure systems, health and safety, environment, quality of radiographs and record-keeping.