We carried out an announced comprehensive inspection on 1 December 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

Church Green Dental Practice is a dental practice providing NHS and private treatment for both adults and children. The practice is based in converted domestic dwelling in Witney, a town situated in Oxfordshire.

The practice has five dental treatment rooms. Two of which are based on the ground floor and a separate decontamination room used for cleaning, sterilising and packing dental instruments. The ground floor is accessible to wheelchair users, prams and patients with limited mobility.

The practice employs four dentists, three hygienist, one dental therapist, five dental nurses, three reception staff and a practice manager.

The practice’s opening hours are between 8.15am and 5.30pm Monday, 8am and 5.30pm Tuesday to Thursday and between 8.15am and 5pm Friday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service via 111.

The provider, E Leondaki, shares the practice facilities with three another dentists, who are separately registered with CQC. Facilities are shared and patients can register with either of the dentists. The dental nurses and support staff are employed jointly by all four dentists.

E Leondaki is registered as an individual and is legally responsible for making sure that the practice meets the requirements relating to safety and quality of care, as specified in the regulations associated with the Health and Social Care Act 2008

We obtained the views of 10 patients on the day of our inspection.

Our key findings were:

• We found that the practice ethos was to provide high quality patient centred dental care in a relaxed and friendly environment.
• Effective leadership was provided by senior clinicians and an empowered practice manager.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff received training appropriate to their roles and was supported in their continued professional development (CPD) by the senior clinicians.
• Staff we spoke with felt well supported by the senior clinicians and practice manager and were committed to providing a quality service to their patients.
• Information from 12 completed Care Quality Commission (CQC) comment cards gave us a completely positive picture of a friendly, caring, professional and high quality service.

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

• Review the systems to meet health and safety regulations with respect to fire; including team fire safety training and the testing of emergency lighting and battery operated smoke detectors.
• Consider providing the hygienist with the support of an appropriately trained member of the dental team.
• Consider providing details of the dentists working at the practice including their General Dental Council (GDC) registration number in accordance with GDC guidance issued in March 2012 on NHS Choices.
• Review patient information and responses to patient comments on the NHS Choices website.
• Review the frequency of staff meetings to ensure that staff have an opportunity to take part in shared learning and provide feedback at least monthly.
• Consider reviewing the contents of the annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the practice's recruitment policy and procedures and check they are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and information required in respect of persons employed by the practice is held.
• Consider implementing a system for collating the records of staff training.

We did not speak with patients at the dental practice as there were very few patients available the day of the inspection visit. We reviewed the information that the dental practice had received during they own patient satisfaction processes conducted during the previous few weeks.