We carried out an announced comprehensive inspection on 7 July 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

Forest Dental - Loughton is a small dental practice situated in a converted house in Loughton, Essex.

The practice has one treatment room, a waiting room and a reception area. Decontamination takes place in a dedicated area within the treatment room (Decontamination is the process by which dirty and contaminated instruments are bought from the treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

The practice has a principal dentist and a trainee dental nurse.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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 practice offers general and cosmetic dental treatments to adults and children on a private basis. The practice also has a small number of NHS patients.

The opening hours of the practice are 8am to 4pm Monday, Tuesday and Thursday, between 8am and 1pm on Friday. The practice is closed on Wednesdays.

We left comment cards at the practice for the two weeks preceding the inspection. 39 people provided feedback about the service in this way. All of the comments spoke highly of the dental care and treatment that they received and the professional, attentive and caring attitude of the dentist and trainee dental nurse.

Our key findings were:

• There was an effective complaints system and learning from complaints was used to make improvements where this was required.
• The practice was visibly clean and clutter free and Infection control practices met national guidance.
• There were a number of systems in place to help keep people safe, including safeguarding vulnerable children and adults.
• Dental care and treatments were carried out in line with current legislation and guidelines.
• Patients reported that they were treated with exceptional care and compassion and staff were understanding, polite and helpful.
• Patients were involved in making decisions about their care and treatments.
• The practice provided a flexible appointments system and could normally arrange a routine appointment within a few days or emergency appointments mostly on the same day.
• The practice kept medicines and equipment for use in medical emergencies. These were in line with national guidance and regularly checked so that they were fit for use.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Governance arrangements were in place for the smooth running of the service.
• Patient’s views were sought and used to make improvements to the service where these were identified.

When we inspected Forest Dental on 09 December 2013 we found that people were provided with information about their treatment and they were asked for their consent. There were consent forms available that provided information about different types of treatment. One person we spoke with said, “I am given written literature with my treatment plan and they ask for my agreement.”

People’s needs were assessed and treatment was planned and delivered in line with those individual needs. People's examinations included an assessment of their general health and their declared medical history as well as photographs and x-rays where appropriate. One person told us, “I always get asked about my medical history at each visit. I also had x-rays last year.”

The provider had ready access to emergency oxygen and medicines, which were all within their expiry dates.

The decontamination cycle and the packaging and storage of instruments were in accordance with Department of Health instructions on decontamination. The environment was clean and hygienic.

The provider and the dental nurse both undertook training that was relevant to their role. They maintained their professional registration by means of continuing professional development.

The provider carried out a range of audits that ensured the safety and welfare of people using the practice. The provider also acted on comments and suggestions to improve the service.