We carried out an announced comprehensive inspection on 17 October 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

Estetica Dental Chertsey is located in Chertsey, Surrey. The premises have six treatment rooms of which three are for dental services and the other three are for cosmetic medical laser treatments which were not inspected as part of this inspection as they are outside the scope of what CQC regulate. In addition to these rooms there was a decontamination room, a small stock room, an x-ray room, a reception area, an office, patient toilet, two waiting areas, and a staff kitchen and changing room. The dental treatment rooms, decontamination room and the x-ray room were located on the ground floor of the building.

The practice provides private dental services mainly to adults and some children. The practice offers a range of dental services including routine examinations and treatment, veneers, crowns and bridges.

The dental team at the practice consists of a principal dentist (who was the owner), two associate dentists, four dental nurses (including two trainee’s), two dental hygienists, and a receptionist. The principal dentist provides conscious sedation services for adult 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 dental specialist advisor.

We reviewed 21 Care Quality Commission (CQC) comment cards that had been completed by patients in the two weeks prior to our inspection. All patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• 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).

• Emergency medicines and equipment was available in accordance with current guidelines but there were airways and two medicines missing.
• Patients were involved in their care and treatment planning so they could make informed decisions.

• Overall there were effective processes in place to reduce and minimise the risk and spread of infection although the service maintenance of the ultrasonic cleaning bath had not been done.
• Although documentation was in place for the reporting of incidents in the practice there was no detail of the risks assessed or any actions taken at the time of the incident.
• The practice appeared visibly clean and well maintained.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection
• Equipment, such the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been serviced. Although the air compressor was an old model that could no longer be serviced by the supplier.

• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients indicated that the team were friendly, caring and provided a pain free service.
• There was a comprehensive induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

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

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result.
• 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).
• Review the protocols and procedures for use of X-ray equipment giving due regard to its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.

• 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 its complaint handling procedures and establish an accessible system for identifying, receiving, recording, handling and responding to complaints by patients.