We carried out an announced comprehensive inspection on 29 September 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

E2 Dental Practice located in Bethnal Green provides a mix of NHS and private dental treatment.

Practice staffing consists of the principal dentist, one associate dentist, one dental nurse, one trainee dental nurse, two receptionists and the practice manager.

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.

The practice is open Monday to Friday 10.00am to 6pm, and every other Saturday10.00am to 3pm.

The practice facilities include two treatment rooms, reception and waiting area, decontamination room and a staff room/kitchen.

25 patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received about the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• There were systems in place to ensure that all equipment was maintained in line with manufacturer’s guidelines.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• The practice ensured staff were trained and that they maintained the necessary skills and competence to support the needs of patients.
• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice.
• The practice had a procedure for handling and responding to complaints, which was displayed and available to patients.
• The practice had not carried out an infection control audit.

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

• Review its audit protocols to ensure infection control audits are undertaken at regular intervals, and where applicable learning points are documented and shared with all relevant staff.
• Review stocks of medicines and equipment and the system for identifying and disposing of out-of-date stock.
• Review its responsibilities as regards to the Control of Substance 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 protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.

We spoke to two people who used the service and both were complimentary about the practice. One who was attending the practice for the first time commented "It was a good experience and not that scary". The other said "The practice is friendly and helpful and that includes the receptionist". They felt that they were well informed about the choices, the cost and possible outcomes of their treatment.

The majority of the staff had been with the practice for a considerable length of time which enabled the practice team to know the users of the service well and deliver quality care in a caring environment.