We carried out an announced comprehensive inspection on 21 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

Causeway Dental Practice is part of the Sussex Health Care Group and operates from the first and second floor of a listed building and provides NHS and private dentistry for both adults and children. The practice is situated in town of Horsham West Sussex. The practice has five dental treatment rooms, and has a separate decontamination room used for cleaning, sterilising and packing dental instruments.

The group employs 11 dentists (including a specialist registered endodontist), five dental hygienists, 13 dental nurses, five of whom are in training, five receptionists, a business development manager and an administrative practice manager. The group also employ three practice cleaners.

The practice opens Monday to Friday between 8.30am and 5pm. Extended hours are available on some late evenings with Saturday’s available for private patients.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. This is provided by an out-of-hours service. If patients called the practice when it was closed, an answerphone message gives the telephone number patients should ring depending on their symptoms.

The administrative practice manager is the registered manager. 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.

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

Before the inspection we sent Care Quality Commission (CQC) comments cards to the practice for patients to complete to tell us about their experience of the practice. We collected 36 completed cards. All the comments from patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Strong and effective clinical and business leadership was evident during our inspection underpinned by an effective governance system that had recently been introduced by the practice.
• 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 effective systems 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 children living in vulnerable circumstances.
• Staff reported incidents and kept records of these and discussed information for shared learning.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Governance arrangements and audits were robust and effective in improving the quality and safety of the services.

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

• Review the arrangements for providing the hygienists with the support of an appropriately trained member of the dental team at all times.