We carried out an announced comprehensive inspection on 28 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

Garden Dental Practice is located in the London Borough of Barnet and provides NHS and private dental treatment to both adults and children. The premises are on the ground floor and consist of four treatment rooms, an X-ray room, a reception area and two dedicated decontamination rooms. The practice is open Monday to Friday 9:00am – 6:00pm and Saturday 9:00am – 2:00pm.

The staff consists of two principal dentists, two associate dentists, two dental hygienists, two dental nurses, a practice manager and a receptionist.

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.

We reviewed 10 CQC comment cards and the NHS Friends and Family test. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Our key findings were:

• There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.
• 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).
• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection.
• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients indicated that they found the team to be efficient, professional, caring and reassuring.
• Patients had good access to appointments, including emergency appointments, which were available on the same day.
• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.

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

• Review the storage of records related to people employed and the management of regulated activities giving due regard to current legislation and guidance.
• Review the practice’s audit protocols of various aspects of the service, such as radiography and dental care records at regular intervals to help improve the quality of service. The practice should also check where applicable audits have documented learning points and the resulting improvements can be demonstrated.
• Review the current staffing arrangements to ensure all dental staff, including hygienists are suitably supported by a trained member of the dental team when treating patients in a dental setting.

We were able to speak to patients of the dental practice. They told us that they had been treated with respect and dignity. They expressed satisfaction with the care and treatment provided. They told us that the dentist was, “professional”, “patient” and “friendly”.

Comments from patients included, “My dentist always puts me at ease”, “I am made to feel very welcome, the staff are very friendly toward me” and “The dentist is always gentle and patient and mindful that I am nervous”.

Detailed assessments and treatment plans had been prepared for patients. Treatment had been given with patients’ agreement and written consent.

The premises were clean and well maintained. There were arrangements for infection control and appropriate checks in place to ensure standards were adhered to. Staff were knowledgeable about infection control and decontamination procedures for equipment and instruments used. Patients told us they were happy with the cleanliness of the practice and said it was “very bright and pleasant".