We carried out an announced comprehensive inspection on 30 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

Lancaster House Dental Practice is a mixed NHS and private dental practice in Croydon. The practice has four dental treatment rooms and two separate decontamination rooms for cleaning, sterilising and packing dental instruments. Also included were a reception and waiting area.

The practice is open 9.00am – 5.30pm Monday, Tuesday, Thursday and Friday; 9.00am to 7.00pm Wednesdays and 9.00am to 1.00pm Saturdays. The practice has six dentists, two oral surgeons, two dental hygienists, five dental nurses, two receptionists’, one administrator and a systems administrator.

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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 26 patients. These provided a positive view of the services the practice provides. Patients commented on the high quality of care, the friendliness and professionalism of all staff, the cleanliness of the practice and the overall high quality of customer care.

Our key findings were:

• Staff had been trained to handle medical emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Infection control procedures were robust and practice staff were carrying out infection control audits periodically.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances. Some of the information relating to safeguarding was outdated.
• The practice had a system in place for reporting incidents which the practice used for shared learning.
• 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 recruitment files were organised.
• There was a structured approach to learning and development and clinical staff were up to date with their clinical professional development.
• Staff we spoke with felt well supported by the leadership team and were committed to providing a quality service to their patients.
• Information from 26 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:

• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

The patients spoke very highly of the Principal and his team, and felt well treated. Patients informed us the dentists always provide detailed information as part of a Personalised Care Plan, and explained their treatment needs and options.

The patients told us they found all staff listened to them, and were very attentive to their needs.

There were effective systems in place to reduce the risk and spread of infection. The premises were modern, and clean, working towards HTM0105 best practice.