We carried out an announced comprehensive inspection on 12 November 2015 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

Karia Dental – Woolwich is located in the London Borough of Greenwich. The premises are situated in a purpose-built building with a single floor on a high-street location. There are four treatment rooms, a dedicated decontamination room, a waiting room with reception area, a staff room, administrative office, and a patient toilet.

The practice provides NHS and private services to adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers, crowns and bridges, and oral hygiene. The practice offers intravenous conscious sedation for some treatments. The practice carries out domiciliary care visits to some elderly patients in care homes.

The staff structure of the practice comprises of a principal dentist (who is also the owner), six associate dentists, one trainee dentist, two dental nurses, three trainee dental nurses, a hygienist, a practice manager, an administrator and two receptionists. The practice is a training practice for the Dental Foundation Training (DFT) scheme. DFT provides postgraduate dental education for newly qualified dentists in their first (foundation) year of practice; usually within general dental practices. The principal dentist is a trainer for the DFT scheme and provides clinical and educational supervision.

The practice opening hours are on Monday and Tuesday from 9.15am to 8.00pm, Wednesday from 9.10am to 6.00pm, Thursday from 8.45am to 5.00pm, Friday from 9.15am to 5.00pm, and Saturday from 9.15am to 1.30pm. The practice is closed for lunch between 1.20pm and 2.20pm each week day.

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

Twenty-four people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• 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).

• There were effective systems 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 children living in vulnerable circumstances.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The principal dentist had a clear vision for the practice and staff told us they were well supported by the management team.
• Governance arrangements and audits were effective in improving the quality and safety of the services.

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

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the list of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure they are current and that appropriate risk management strategies are in place.
• Review the system of stock checks to ensure that out-of-date products are disposed of in a timely manner.
• Establish a system for reviewing the suitability and cleanliness of the equipment used in domiciliary care visits.

People using the service we spoke with said they received a very good service. Most had been using the service for many years and said they would recommend it to their family and friends. They told us they were provided with clear information about treatments, options and potential costs and said their oral health had improved as a result of the care and treatment they had received. They told us the practice was always clean and hygienic and that staff were friendly and polite. One person said; “The dentist explain things fully to me in a way I can understand”. Another person said; “They are welcoming, professional and know what they are doing”.

We found people using the service were involved in decisions about their care and were treated with dignity and respect. They experienced treatment and care that met their needs, and were cared for by suitably qualified, skilled and experienced staff. People were protected from the risk of infection, and the provider had systems in place to monitor the quality of the service people received.