We carried out an announced comprehensive inspection on 09 March 2017 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

Donovan’s Dental Practice is located in the town of Petworth. The practice provides private dental and a small amount of NHS treatment to both adults and children.

The premises are on the ground, first and second floor and building works are currently underway to convert loft space into a clinical space.

The practice consists of three treatment rooms, a reception and patient waiting area and a decontamination room. The practice is open on Monday to Thursday from 9am to 5.30pm and Friday from 8am to 4.30pm. The staff consists of the principal dentist, two associate dentists, one dental hygienist, three qualified dental nurses, one trainee nurse, two receptionists and a practice manager who is also a qualified dental nurse.

The practice manager 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 48 CQC comment cards. Patients were very positive about the service. They were complimentary about the friendly and helpful attitude of the staff who they said provided excellent care.

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

Our key findings were:

• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients had good access to appointments, including emergency appointments, which were available on the same day.
• There was a process in place for the reporting of untoward incidents that occurred in the practice
• The dental care records we saw showed that dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines, though improvements were needed to ensure suitable documentation of consent and discussions with patients.
• The practice had all emergency medicines and most equipment in line with the British National Formulary (BNF) guidance for medical emergencies in dental practices and the Resuscitation Council (UK) guidelines.
• The practice had safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection.
• Improvements could be made to the decontamination procedures to ensure that national guidance for infection prevention control in dental practices (HTM 01 05 guidelines) were followed.
• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.
• There were good governance arrangements, though some improvements could be made to ensure policies were regularly reviewed and updated and necessary risk assessments completed.

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

• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting.
• Review the practice’s infection control procedures and protocols in accordance with 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 training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.
• 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 use of audits to help monitor and improve the quality of service. The practice should also check that where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
• Review the practice’s systems for reviewing and updating its risk assessments, policies and procedures with respect to the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR); Health and Safety Risk Assessments.
• Review the practice’s protocols for domiciliary visits taking into account the 2009 guidelines published by British Society for Disability and Oral Health in the document “Guidelines for the Delivery of a Domiciliary Oral Healthcare Service”.

We spoke with three people during our visit and met with a further three as they attended their appointments. Everyone that we spoke with was pleased with the service and treatment they had received. One said, “I’m absolutely satisfied”. Another told us, “They are very reassuring”. A third explained, “I’m a little bit dentist phobic but they are exceptionally good”.

We spoke with the provider, the manager and three members of staff. Staff told us that it was a great place to work. One said, “There’s such good team support here”. Another told us, “I love the people that I work with”.

We found that the practice was vibrant and well run. People were offered choices about the care that they received and were cared for in a safe and clean environment. The surgeries were well equipped. Where people needed level access they could be treated on the ground floor.

People appeared to feel comfortable using the service and related easily to the staff. They spoke enthusiastically about the waiting area. One said, “It’s more like a coffee shop than a dentist’s waiting room, I love the fact that they serve coffee”. Staff had made an effort to make the waiting area inviting. We saw that magazines, a daily paper and books on the local area were provided. There was also an area for children. We observed staff interacting with people in a kind and cheerful manner.