We carried out an announced comprehensive inspection on 3 February 2017 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

Cavendish Dental Surgery is a dental practice providing NHS and private treatment for both adults and children. The practice is based in a converted residential property.

There are two treatment rooms located on the ground floor, a dedicated decontamination room for sterilising dental instruments and a staff kitchen. There are additional rooms upstairs, one of which is in use by a local physiotherapy service. Parking for disabled patients is available on the drive with additional car parking available on the side-streets near the practice. The practice is accessible to people with disabilities and impaired mobility.

The practice employs two dentists, one dental nurse and a full time receptionist. The practice’s opening hours are 9am to 1pm and 2pm to 5pm Monday, Tuesday, Wednesday and Friday and 9am to 2.30pm on Thursdays.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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 29 CQC comment cards on the day of our visit; patients were extremely positive about the staff and the standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• The premises had undergone refurbishment and were visibly clean and tidy.
• The practice had procedures in place to record and analyse significant events and incidents.
• Staff had received safeguarding training, and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified, skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available but some minor adjustments were necessary to comply with Resuscitation Council UK guidelines.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.

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

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the storage of dental care products and medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.
• Review its audit protocols to document learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.
• Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.

During our inspection we spoke with the three dentists working at the practice, two members of staff and three people who used the service.

The people we spoke with were complimentary about the service they received. Some of the comments we received were; “They are very kind, friendly and professional,” “I can’t sing his (the dentist) praise enough” and “I have a lot of trust in him (the dentist).”

We were told that treatment options were always discussed with people and any questions were fully answered.

We were told that people had their privacy and dignity respected. One person said “They are very, very respectful and always have been.”

We looked at the cleanliness of the practice and the safety processes that they had in place to protect the health of their patients. People told us that the dental practice was always clean and tidy when they attended.

We looked at their complaints procedure and found that it was clear and was available for people to access.