We carried out an announced comprehensive inspection on 15th September 2015 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

Clifton Dental Practice is a mixed dental practice providing private care for adults and NHS treatment for children. The practice was situated in a converted commercial shop property. There were two dental treatment rooms, although one was no longer used. A separate room housed the practice autoclave (a device for sterilising instruments) and an automatic X-ray developing machine. The treatment and waiting rooms were on the ground floor enabling disabled access.

The practice had one full time dentist who was supported by one dental nurse and two receptionists. The practice opening hours were: Monday, Tuesday, Thursday and Friday 9:00 am to 5:30 pm and Wednesday 9:00am to 1:00pm. The practice closed from 1:00 pm to 2:00 pm each day for lunch.

The provider is also 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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We collected 16 completed cards and spoke to five patients. All of the feedback was extremely positive about the care patients received from the practice.

Our key findings were:

• Staff had been trained to handle emergencies and appropriate medicines and oxygen was readily available in accordance with current guidelines.

• Patients’ needs were assessed and care was planned and delivered in line with current professional guidelines.

• All equipment used in the practice was well maintained in accordance with the manufacturer’s instructions. The practice was generally visibly clean and maintained.

• The practice had enough staff to deliver the service. Staff felt well supported by the registered manager and were committed to providing a quality service to their patients.

• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).

• Information from 16 completed CQC comment cards gave us a positive picture of a friendly, caring and professional service.

• The practice had systems to assess and manage risks to patients for infection prevention and control (IPC) but was not carrying out IPC audits to test the effectiveness of infection control procedures.

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

• Make more detailed records of the care and treatment provided to patients giving due regard to professional standards in relation to clinical record keeping and IRMER 2000 regulations.

• Review professional guidelines in relation to obtaining informed consent and establish a system for auditing clinical records.

• Implement infection control systems giving due regard to national guidelines generally and with specific respect to manual scrubbing of contaminated instruments and environmental cleaning of the practice. Establish a process to audit and monitor infection prevention and control arrangements at the practice.

• Update their policies and procedures for the safe use of dental sharps by carrying out a risk assessment to reflect the requirements of the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 and the EU Directive on the safer use of sharps which came into force in 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.

We spoke with a number of people about the service. They included two dentists, a dental nurse/receptionist and a random selection of patients. This was in order to gain a balanced overview of what people experienced using this dental practice.

We spoke with people who used the surgery about how they were treated and what support they received. They told us staff discussed their treatment options and they were given time to make informed choices. Comments included,

Patients we spoke with told us they found staff were polite, courteous and made them feel at ease. One person told us, “I have been coming here for a long time, they have always been very kind and helpful”.