We carried out an announced comprehensive inspection on 24 August 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

Croydon Dental Practice is a mixed NHS dental and orthodontic practice in Croydon. The practice is set out over one floor (ground floor) and has two dental treatment rooms, a patient waiting room with reception, and a staff office.

The practice is open 9.00am to 7.00pm Monday and Thursdays; 9.30am to 5.00pm Tuesdays and Wednesdays and by appointments on Fridays. The practice has two dentists, one dental nurse and a receptionist.

The principal dentists are the registered managers. 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 received feedback from 21 patients via completed comment cards and speaking with patients on the day of the inspection. Patients provided a positive view of the services the practice provides. They commented on the quality of care, the friendliness and professionalism of all staff, the cleanliness of the practice and the overall quality of customer care.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment. Leadership was clear and roles and responsibilities well defined.
• Staff had been trained to handle emergencies, and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Infection control procedures were in place, although there was evidence that they were not fully following guidance issued by the Department of Health, namely 'Health Technical Memorandum 01-05 -Decontamination in primary care dental practices (HTM 01-05). Audits were being completed every six months.
• The practice had a safeguarding lead with information available to staff to refer to. Staff demonstrated knowledge of safeguarding.
• The practice had a system in place for reporting incidents which the practice used for shared learning.
• Dentists told us they provided care within current professional and National Institute for Health and Care Excellence (NICE) guidelines although this was not always evidenced in dental care records.
• 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 recruitment files were well organised and included relevant pre recruitment documents such as interview notes, CVs and references.
• Staff had the opportunity to attend learning and training events.
• Staff we spoke with felt well supported by the practice owner and were committed to providing a quality service to their patients.
• Feedback from patients gave us a positive picture of a friendly, caring, professional and high quality service.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society
• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice’s infection control procedures and protocols are suitable taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice’s audit protocols to ensure radiography audits are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.

On the day of the inspection we spoke with five people who used the service. They told us the staff were all friendly and they were usually seen punctually at their appointment time. They said that the costs and possible treatment options were fully explained to them at their appointments. One person told us “All the staff are lovely here.” Another commented "I cannot fault this practice, it is the best and I am not just saying that.” They all said they were pleased with the treatment they had received.

We looked at some of the surgery records. We saw people had treatment plans which took into account their relevant medical history, explained the costs and recorded their treatment needs, options and advice.

Some people said they had been coming to the practice for a long time and felt confident in the dental care provided. People told us they felt the practice treatment rooms were clean. We saw the practice had clear infection control systems in place. All areas of the practice were visibly clean with suitable flooring and surfaces in place to reduce the risk of infection.

We spoke with staff and looked at staff records and saw that staff had regular training. We looked at other practice records and found that the provider undertook clinical and infection control audits to monitor and review the quality and safety of the service.