We carried out an unannounced comprehensive inspection on 12 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

Euro Dental Oxford is a dental practice providing NHS and private treatment for both adults and children.

The practice is situated in Headington a suburb of Oxford. The practice has one dental treatment room and a separate decontamination room used for cleaning, sterilising and packing dental instruments. The practice is based on the first floor above a retail fast food business.

The practice employs one dentist, two dental nurses of whom one is a trainee. This member of staff also covers reception duties and a practice manager who manages two practices belonging to the provider.The practice’s opening hours are 8.00am to 5.30pm Monday to Thursday and Friday 8.00am to 1.00pm and Saturdays by special arrangement.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service. The practice has opted out of providing out-of-hours services to their own patients and refers them to South Central Ambulance Service via the NHS 111 service.

The practice manager 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.

During our inspection we reviewed 11 CQC comment cards completed by patients and obtained the view of five patients on the day of our inspection.

The inspection was carried out by a CQC specialist dental inspector.

Our key findings were:

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.

• The practice appeared clean and maintained.

• Infection control procedures followed published guidance.

• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.

• Staff reported incidents and kept records of these which the practice used for shared learning.

• The dentist provided dental care in accordance with current professional and National Institute for Care Excellence guidelines.

• The service was aware of the needs of the local population and took these into account in how the practice was run.

• Patients could access treatment and urgent and emergency care when required.

• Staff recruitment files contained essential information in relation to Regulation 18, Schedule 3 of Health & Social Care Act 2008 (Regulated Activities) Regulations 2015.

• Staff received training appropriate to their roles and were supported in their continuing professional development by the practice manager.

• Staff we spoke to felt supported by the practice manager and were committed to providing a quality service to their patients

• Information from 16 patients gave us a positive picture of a friendly and professional service.

• The practice manager provided effective leadership for staff working at the practice.

• The practice reviewed and dealt with complaints according to their practice policy.

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

• Review the practices’ appraisal process to include a formal pre-appraisal document to capture the employee’s progress and aspirations since the previous appraisal.

• Review the audit process for the quality of radiographs to include an analysis of the various grades of quality of X-rays over each audit cycle.

• Review standards in relation to clinical record keeping in accordance with the guidance as set out by the Faculty of General Dental Practice.

• Consider using other appropriate safety measures to prevent inhalation or swallowing of root canal instruments during root canal treatment when a rubber dam is not used.

• Consider obtaining a hearing loop for patients with hearing impairments.

During our visit to Eurodental Oxford we met with the practice manager. We spoke with six patients either on the day of the visit or by telephone. We met with the dentist and spoke with two members of staff.

Patients were able to access dental treatment at times convenient to their needs and were very happy with the treatment they had received. One patient told us "I have been at many dentists and he [the dentist] is the best. He is very nice and kind". A second patient said "I have had fillings elsewhere that have fallen out. The fillings he [the dentist] does stay in".

Patients we spoke with told us the practice was always clean and tidy. The practice operated processes, and followed procedures, that minimised the risk and spread of infection because current guidelines were followed.

Staff told us they were supported to carry out their roles. We saw that staff received training specific to their job and that they received an annual review of their performance. A member of staff we spoke with said "We get a lot of help here. If I don't know anything I can always ask and get an answer".

The practice had systems in place to seek and act on patient feedback and carried out audits to monitor clinical quality.