We carried out an announced comprehensive inspection on 19 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

Churchfield Dental Centre is a purpose built two story practice providing mainly private and NHS treatment to patients of all ages. The practice comprises four treatment rooms, four oral hygiene education rooms, a large waiting and reception area and a second waiting area on the first floor with a reception area. There is a decontamination room for sterilising dental instruments on both floors, a staff room/kitchen and two general offices.

Access for wheelchair users or pushchairs is possible from a step free entrance which leads into the reception and waiting area. The practice is located adjacent to a health care complex site which includes a pharmacy, doctor’s surgery and a children’s day centre. Dedicated car parking is available within the complex parking area.

The dental team is comprised of a principal dentist and an associate dentist, two dental hygiene therapists, eight dental nurses and three trainee dental nurses, three receptionists, a business administrator/receptionist, a patient co-ordinator and a practice manager.

The practice is open:

Monday and Tuesday 8:30am – 5:00pm

Wednesday 1:00pm – 8:00pm

Thursday 8:30am – 5:00pm

Friday 8:30am – 5:00pm

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person. 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.

On the day of inspection we spoke with two dentists, one dental hygiene therapist, four dental nurses, two receptionists, the patient co-ordinator and the practice manager. We received 14 CQC comment cards providing feedback. The patients who provided feedback were very positive about the care and attention to treatment they received at the practice. Patients commented they were involved in all aspects of their care and found the staff to be caring, reassuring and helpful. They stated staff were good at communicating information, they could access emergency care easily and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, health and safety and the management of medical emergencies.
• The practice was visibly clean and uncluttered.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it. They had very good systems in place to work closely and share information with the local safeguarding team.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in accordance with the published guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Treatment was well planned and provided in line with current best practice guidelines.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The practice was well-led and staff felt involved and supported and worked well as a team.
• The governance systems were effective and embedded.
• The practice sought feedback from staff and patients about the services they provided.
• There were clearly defined leadership roles within the practice and staff felt supported at all levels.

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

• Review the safekeeping of emergency medicines to ensure appropriate security is maintained.
• Review the process of monitoring the temperature of the emergency medicines fridge and ensure emergency medicine stock requirements are updated.
• Review the process for recording and checking the functionality of the AED to bring in line with the British National Formulary (BNF) and Resuscitation Council UK guidelines.
• Review the practice’s process on latex use and produce a latex policy.
• Review the practice’s risk in the decontamination room with respect to lack of hand washing facilities and produce a risk assessment to mitigate the risk of cross contamination.
• Review the practice’s refurbishment process to implement a hand washing sink in the decontamination rooms to bring in line with guidance from 'Health Technical Memorandum 01-05 -Decontamination in primary care dental practices (HTM 01-05)'.
• Review the practice policy on referring patients to the dental hygiene therapist, ensuring a more thorough referral process is put in place.
• Review the practices policy on lone working and implement a lone working policy.

We spoke privately with three people who were attending the practice for check ups or treatment. They told us that they were "very happy" with all aspects of the service. They told us that staff were "very good" and “very friendly". People said that the dentist always explained treatment options to them. One person told us, "I am always included in discussions about my treatment. The dentist talks through everything with me." People spoken with said that they felt safe in the care of the dentists and that they found all members of the staff team polite and respectful. One person said, "they are excellent. The staff are polite and friendly and they respect confidentiality."

People spoken with told us that they had no worries or concerns about the practice. One person said, "I can talk to my dentist about anything, all the staff are approachable."

We found people received care and treatment in a clean environment with infection control measures in place to minimise the risk of infection. People spoken with said that the surgery was always clean. One person said, "I've always found it very clean."

The provider had an appropriate system in place for gathering, recording and evaluating information about the quality and safety of care the service provided. People who used the service and their representatives were asked for their views about their care and treatment.