We carried out an announced comprehensive inspection on 14 March 2017 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.

Hamsey Green Dental Surgery is a mixed NHS and private practice in Warlingham, Surrey which offers a range of general dental treatment to adults and children. The premises are located on the ground and first floor of a converted residential property and consist of four dental treatment rooms, a reception and waiting area and a separate decontamination room.

The staff at the practice consist of a principal dentist, six associate dentists, a practice manager, two dental nurses, four trainee dental nurses and two receptionists.

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.

Our key findings were:

• There was an induction programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers and the X-ray equipment.

• We found the dentists regularly assessed each patient’s gum health and the dentist took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• The practice placed an emphasis on the promotion of oral and general health and the prevention of dental disease. Appropriate information and advice was available according to patients’ individual needs.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received assessments of their oral health needs. They were given clear explanations about their proposed treatment, and its costs, benefits and risks and were involved in making decisions about it.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were kind, caring, very welcoming and worked well as a team.

• There was an effective system in place to act on feedback received from patients and staff.

• We reviewed 36 CQC comment cards that had been completed by patients prior to our inspection. Common themes were patients felt they received excellent care in a calm and hygienic environment from staff who were caring, reassuring and informative. Several patients specifically commented how staff had been particularly supportive with their anxieties and had taken time to put them at ease.

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

• Review the practice's recruitment policy and procedures to ensure character references for new staff as well as proof of identification are requested and recorded suitably.

Patients who used the service told us that they were provided with good information about treatment options and the associated costs and were able to ask all the questions they wanted to.

Patients told us they felt they had enough time and information to make decisions about their treatments. Comments included; "The dentist will take the time to explain to me what treatment I need", "They always talk you through what is happening " and "they’re a good crew!".

Patients told us that staff were "Friendly" "Professional" and "Really nice". Patients said they were treated with respect and their privacy was protected. One patient told us “They’re the best dentists I have ever been to” whilst another patient said "The staff will put you at ease here".

Patients said that the appointment system worked well and that the service was clean and comfortable.