We carried out an announced comprehensive inspection on 7 March 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 responsive care in accordance with the relevant regulations.

Background

Farlington Dental Practice is a dental practice providing private treatment for both adults and children.

The practice is situated in a converted domestic dwelling situated north of Portsmouth, Hampshire. The practice has two dental treatment rooms and a separate decontamination room used for cleaning, sterilising and packing dental instruments.

The practice employs a dentist, hygienist, dental nurse, receptionist and a practice manager. The practice’s opening hours are Monday and Wednesday 9am to 5.30pm, Tuesday 2pm to 7pm and Thursday and Friday 9am to 1pm. There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed.

Mr. Shahram Erfanmanesh is registered as an individual and is legally responsible for making sure that the practice meets the requirements relating to safety and quality of care, as specified in the regulations associated with the Health and Social Care Act 2008.

During our inspection we reviewed 12 CQC comment cards completed by patients and obtained the view of 12 patients on the day of our inspection

We carried out an announced comprehensive inspection on 7 March 2016 as part of our planned inspection of all dental practices. Our inspection was carried out by a lead inspector and a dental specialist adviser.

Our key findings were:

• The practice philosophy was to provide high quality patient centred care with an emphasis on the prevention of dental disease at all times

• 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 manager acted as the safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.

• A system was in place to report incidents with practice meetings used as a vehicle 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 19, 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.

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

• Information from 12 completed Care Quality Commission comment cards gave us a completely positive picture of a friendly, caring, professional and high quality service.

• The practice received no complaints throughout 2015

This was an unannounced responsive inspection because concerns had been raised about the lack of effective systems to protect patients against the risk of unsafe care. We used a specialist dental adviser to assist in our inspection.

On arrival at the location it was found that the dentist was attending a training course and there was only the practice manager on duty at the surgery. There were no patients booked into the practice on that day as the dentist was not available.

We were able to speak with the practice manager and review policies and records. We were also able to inspect the surgeries without causing any inconvenience to patients.

People who used the service were given appropriate information and support regarding their care or treatment.

We saw an up to date policy on consent that detailed the way in which the practice respected the wishes of patients and was robust in ensuring that decisions about their care must be made by the patient and without pressure.

The manager had a good awareness of the issues regarding the protection of vulnerable adults and children and of whom to contact should there be concerns in this area.

We found that some of the recommendations made within HTM 01-05 were not being followed for example work surfaces in one of the surgeries appeared cluttered. This meant that effective cleaning of these areas was not always possible.

We spoke with the practice manager and to the dentist.

We spoke to three people who used the service, each of whom said they were satisfied with the service they received.

People told us that they were given a range of options and that they were able to make informed decisions on what treatment they received. People said they were given a treatment plan detaining the planned treatment including the costs.

People said they were treated well by the staff at the dental practice. One person said they were offered a drink when they arrived and said the dentist and the staff provided reassurance when the person was anxious about treatment.

The dental practice had policies and procedures regarding the safeguarding of vulnerable adults and children. We identified that the dental practice did not have policies and procedures regarding the treatment of people who did not have capacity to consent to treatment.

People knew how to make a complaint but told us they had not had cause to use it.

We saw the dental practice had infection control procedures for the cleaning and sterilisation of equipment. People told us the dental practice was always clean and they were satisfied with the standards of hygiene.

The dental practice was subject to annual audits by a dental payment specialist. This covered patient consent, clinical audits, premises, infection control and information for patients.