We carried out an announced comprehensive inspection on 24 October 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.

Chatham Dental Surgery is a NHS general dental practice in the heart of Chatham. The practice is located on the first floor above commercial premises and consists of three dental treatment rooms, a reception area and waiting room and a separate decontamination room.

The staff at the practice consist of a principal dentist, two associate dentists, a practice manager, a dental nurse, two trainee dental nurses and a receptionist.

The principal dentist 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.

Our key findings were:

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• 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 dentists regularly assessed each patient’s gum health and the dentist 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.

• Patients received appropriate assessments of their oral health needs. They were given clear explanations about their proposed treatment, and its costs, benefits and risks and were involved in making decisions about it.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• 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 and worked well as a team.

• There was a system in place to act on feedback received from patients and staff.

• We reviewed 26 Care Quality Commission (CQC) comment cards that had been completed by patients prior to our inspection. Common themes were patients felt they received a high standard of care in a hygienic environment from staff who were caring and respectful.

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

• Review the practice’s radiography audit protocols to include all dentists. Audits should have documented learning points so that any resulting improvements can be demonstrated.

• Review the practice protocols for the recording of references when employing new staff.

We visited the surgery and looked at documents and spoke with staff. We also carried out phone interviews of people who used Chatham Dental Surgery. Before people received any care or treatment, they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

One patient told us, “The dentist is excellent, I am a baby where the dentist is concerned, but they explain everything, talk to me all the way through, sometimes they have finished and I have not even realised, very happy”.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

We spoke with one patient who used the practice about their experience of Chatham Dental Surgery. They told us that they liked the practice. They commented, "I have been using this practice for many years, they are very good and helpful. I get appointments when I need them and I don’t have to wait long. They are very pleasant”.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to make sure all staff had the relevant training to identify the possibility of abuse and prevent abuse from happening.

There were effective systems in place to reduce the risk and spread of infection.

Appropriate checks were not undertaken before staff began work.

The provider had an effective system to regularly assess and monitor the quality of service that people received.