We carried out an announced comprehensive inspection on 12 August 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

Kingsbury Dental Practice is located in the London Borough of Brent and provides NHS and private dental treatment to both adults and children. The premises are on the first floor above retail premises and consist of three treatment rooms, a reception area and a dedicated decontamination room. The practice is open Monday to Friday 9:00am – 6:00pm.

The staff consists of the principal dentist, two associate dentists, three dental nurses, a trainee dental nurse and two receptionists.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual ‘registered person’. 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 17 CQC comment cards, the practice patient satisfaction survey 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:

• 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 availability of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.

We carried out this inspection to check if the provider had complied with a compliance action from a previous inspection of the service. We spoke with two patients, the principal dentist, two members of staff and checked records to make a judgement as to whether the provider was meeting Outcome 21 : Records and was compliant with Regulation 20 (HSCA 2008 Regulated Activities) Regulations 2010.

At this inspection patients we with were happy with the care provided and felt that their records were well kept. Staff were aware of the importance of maintaining accurate and up to date records. We found that the provider had taken proper steps to ensure that people were protected from the risks of unsafe or inappropriate care and treatment because appropriate records and information related to the management of the regulated activity were well maintained.

During this inspection we spoke with three patients and a relative. They indicated that patients were well cared for and staff were respectful towards them. They expressed satisfaction with the treatment provided. Their views can be summarised by the following comment, “I am very pleased. The staff are friendly and respectful. The treatment is good.”

Staff had been informed to treat all patients with respect and dignity. They had an understanding of the cultural background of people and some staff were able to speak the languages of patients whose first language was not English.

Patients expressed confidence in the dentists and other staff who attended to them. Assessments and treatment plans had been prepared for patients. Treatment options had been explained to them and treatment had been given with their agreement and written consent.

The premises were clean and equipment used had been regularly maintained. There were arrangements for the prevention of infections. Staff were knowledgeable regarding infection control and decontamination procedures for equipment and instruments used.

Some essential records and policies associated with the running of the practice were either not available or had not been well maintained. These information and records were needed to ensure that people who use the service are protected against unsafe or inappropriate care or treatment.