Further to the outcome of a previous inspection, carried out in April 2016, we carried out an announced focused inspection relating to the well led provision of services on 7 December 2016 to ask the practice the following key question;

Are services well-led in relation to governance; specifically staff recruitment?

Our findings were:

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

CQC inspected the practice on 19 April 2016 and asked the provider to make improvements regarding:

• Regulation 19 HSCA (RA) Regulations 2014 Fit and Proper Persons employed

We checked this area as part of this focused inspection and found this had been resolved.

Fair Oak Dental Practice operates from a purpose built dental premises providing private treatment for both adults and children. In addition to general dental services Fair Oak provides sedation for nervous patients, dental implants and minor oral surgical procedures.

The practice is situated in Fair Oak Village, a suburb of Eastleigh, Hampshire. The practice has three dental treatment rooms. One is based on the ground floor. Decontamination is carried in individual surgeries following a common protocol.

The practice employs two dentists, a hygienist, two dental nurses and a receptionist. One dental nurse carries out reception duties while the second dental nurse is also the practice manager.

The practice opens 9am to 12pm and 2pm to 5pm on Monday and Thursday and 9am to 12pm on Tuesday, Wednesday and Friday.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. An emergency number is left on the practice phone for the patients to call outside the above hours for advice and answered by the dentists evenings and weekends. When the dentists are away on training or holiday emergency cover is provided by arrangement with a nearby practice.

One of the partners in the practice 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 was carried out by a CQC inspector.

Our key findings were:

• Staff recruitment files contained essential information in relation to Regulation 19, Schedule 3 of Health & Social Care Act 2008 (Regulated Activities) Regulations 2015..

We spoke with four people who were attending the dental practice on the day of our visit. They all told us that they had no problems in making appointments. One person told us how helpful the receptionist had been in arranging a convenient time for them. One person we spoke with told us that they were very nervous of the dentist at their first appointment and found that the dentist had put them at ease

We carried out an announced comprehensive inspection on 19 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 not providing well-led care in accordance with the relevant regulation.

Background

Fair Oak Dental Practice operates from a purpose built dental premises providing private treatment for both adults and children. In addition to general dental services Fair Oak provides sedation for nervous patients, dental implants and minor oral surgical procedures.

The practice is situated in Fair Oak Village, a suburb of Eastleigh, Hampshire. The practice has three dental treatment rooms. One is based on the ground floor. Decontamination is carried in individual surgeries following a common protocol.

The practice employs two dentists, a hygienist, two dental nurses and a receptionist. One dental nurse carries out reception duties while the second dental nurse is also the practice manager.

The practice opens 9am to 12pm and 2pm to 5pm on Monday and Thursday and 9am to 12pm on Tuesday, Wednesday and Friday.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. An emergency number is left on the practice phone for the patients to call outside the above hours for advice and answered by the dentists evenings and weekends. When the dentists are away on training or holiday emergency cover is provided by arrangement with a nearby practice.

One of the partners in the practice 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 38 CQC comment cards completed by patients and obtained the views of six patients on the day of our inspection.

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

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.

• 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 well maintained.

• Infection control procedures were robust and the practice 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.

• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) 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 had received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice owner

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

• Information from 38 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

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

We identified regulations that were not being met and the provider must:

• Ensure the practice recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.

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

• Review fire safety checking systems.

• Consider installing a hearing loop and adding a grab rail in the ground floor patient toilet.

• Consider providing the hygienist with the support of an appropriately trained member of the dental team.

• Review storage arrangements for Glucagon.

• Review MHRA notifications and alert management systems.