We carried out an announced comprehensive inspection on 4 October 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

Halford House is a dental practice providing NHS and private treatment for both adults and children. The practice is based in a converted office building situated above commercial premises in Newbury, a town located in Berkshire.

The practice has five dental treatment rooms. All of which are based on the first floor and a separate decontamination room used for cleaning, sterilising and packing dental instruments. The practice is situated on the first floor of the building; patients with limited mobility are sign-posted to nearby dental services with ground floor access.

The practice employs four dentists, two hygienist, one qualified dental nurse, four trainee dental nurses, three receptionists and a practice manager.

The practice’s opening hours are 8am to 1pm and 2pm to 5pm from Monday to Thursday and 8am to 1pm and 2pm to 3pm on Friday.

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 manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 obtained the views of 10 patients on the day of our inspection.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Effective leadership was provided by an empowered practice manager. The practice also benefited from the presence of three dentists who had worked at the practice for five or more years.
• 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.
• There was appropriate equipment for staff to undertake their duties, and equipment was 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.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
• 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 received training appropriate to their roles and were supported in their continued professional development (CPD) by the company.
• Staff we spoke with felt well supported by the practice manager and were committed to providing a quality service to their patients.
• Information from 16 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

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

• Consider providing the hygienist with the support of an appropriately trained member of the dental team.
• Review the contents of the annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections’ and related guidance. Specifically, this pertains to what the practice has carried out with respect to the training of staff and the policies reviewed.
• Consider the availability of more than one kit of root canal accessory instruments.
• Remind staff that doors to treatment rooms must remain closed at all times when patients are being treated.
• Review the suitability of having an evacuation chair on the premises.
• Consider the provision of an external name plate providing details of the dentists working at the practice including their General Dental Council (GDC) registration number in accordance with GDC guidance issued in March 2012.
• Review NHS Choices and the practice’s own web pages to reflect up to date staff names, location and patient accessibility information.