Background

Dental Care Centre is located in the London Borough of Haringey. The practice provides NHS and private dental treatment to both adults and children. The premises are on the ground floor and consist of three treatment rooms, an X-ray room and a reception area. The practice is open on Monday - Friday 08:30am – 5:30pm and Saturday 08:30am – 3:30pm.

The staff consists of the principal dentist, five associate dentists, three dental hygienists one of whom is a dental therapist, five dental nurses, a trainee dental nurse, a practice manager and a receptionist.

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.

We reviewed 24 CQC comment cards and the NHS Friends and Family test. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Our key findings were:

• There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection.
• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients indicated that they found the team to be efficient, professional, caring and reassuring.
• Patients had good access to appointments, including emergency appointments, which were available on the same day.
• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.

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

• Review its responsibilities as regards to the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review the storage of records related to people employed and the management of regulated activities giving due regard to current legislation and guidance.
• Review availability of medicines 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.

The practice staff were friendly welcoming and informative. The practice was clean and well maintained.

There were effective systems in place to reduce the risk of infection. The decontamination took place within the surgery and in a separate decontamination area. The dental nurse was able to describe the decontamination process to us and provide evidence to show that the correct checks were carried out on the decontamination equipment.

We spoke to two patients who used the service and they told us the practice staff were helpful and listened to you and emergency treatment was offered on the same day. One patient told us they had been a patient for 16 years and were 'really happy as a patient here', They told us that they had recommended the practice to family and friends.

We looked at the comments from a patient survey which included 'I am very pleased with all aspects of my treatment' and 'Receiving texts reminding me of my appointment is helpful'.

We saw evidence that patients had consented to treatment and the staff were well trained and caring.