We carried out an announced comprehensive inspection on 22 April 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

Dental Solution is located in the London Borough of Croydon and provides predominantly NHS dental services. The demographics of the practice were generally mixed, serving patients from a range of social and ethnic backgrounds including from the local Polish community.

The practice staffing consists of three dentists, three dental nurses and a receptionist.

The practice is open from 9.00am to 5.00pm on Monday to Fridays and 9.00 to 2.00pm on Saturdays. The practice is located on the first floor of the building and there is a lift for patients with mobility problems. The facilities include three consultation rooms, a reception area, patient waiting room, decontamination room, staff room/kitchen. The premises were wheelchair accessible including a wheelchair accessible toilet for patients.

The principal dentist is 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.

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

We received 44 completed Care Quality Commission comment cards. Patient feedback was very positive about the service. Patients told us that staff were professional and caring and treated them with respect. They gave examples of where staff had shown empathy and were friendly. Patients also commented on the good availability of appointments and the practices’ willingness to accommodate urgent appointments. They commented that the premises was always clean and tidy and they described the service as very good and providing an excellent standard of care.

Our key findings were:

• Appropriate systems were in place to safeguard patients from abuse
• The provider had emergency medicines and equipment such as oxygen and an automated external defibrillator (AED) in line with national guidance.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• All clinical staff were up to date with their continuing professional development.
• Patients’ needs were assessed and care was planned in line with current guidance.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• Governance arrangements were in place for the smooth running of the practice. Leadership was clear and audits were completed for continuous improvements.

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

• 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 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 of various aspects of the service, such as radiography and dental care records and infection control at regular intervals to help improve the quality of service. Practice should also check that where applicable audits have documented learning points and the resulting improvements can be demonstrated.

People told us they were happy with the dental service they received from the practice. They told us the cost of treatment was always given before any treatment was carried out. People said they were supported to make decisions and choices regarding their care and treatment. One person said “The dentist always discusses any treatment I need and gives me the option to choose. I can go away and think about it.” Another person told us “The dentist always explains what is going to happen before I am treated and this makes me feel at ease.”

People had treatment plans which set out their treatment needs and costs.

People told us they did not have to wait too long for appointments and that they were always seen within 24 hours if they were in pain. One person said “They fit you in on the same day if you have a problem and it is an emergency.”

People commented to us that they thought the surgery and practice building were clean. One person said “The surgery is very bright and airy, it is always clean.”

We spoke with the staff who told us they were well supported to ensure they were up to date in their clinical practice.

Although the provider undertook regular audits to monitor and review the quality and safety of the service provided, there were some improvements needed.