We carried out an announced comprehensive inspection on 13 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

London Day Surgery Centre is located in the London Borough of Barnet and provides NHS and private specialist treatment to both adults and children. The practice provides specialist services. Services are provided by specialist and dentist with special interest in oral surgery, endodontics and periodontics. The premises are on the first floor and consist of four treatment rooms, two decontamination rooms, three consultation rooms, an X-ray room, a recovery room and two reception areas. The practice is open Monday – Thursday 8:30am – 5:30pm and Friday 8:00am – 3:00pm.

The staff consists of the principal dentist, a managing director, ten associate dentists, an anaesthetist, six dental nurses, a receptionist, an administrator and the practice manager.

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.

We reviewed 14 CQC comment cards, the NHS Friends and Family test, NHS Choices and the practice patient satisfaction survey. 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:

• 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.
• 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 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 storage of records related to people employed and the management of regulated activities giving due regard to current legislation and guidance.
• Review the practice’s protocols for medicines management and stock control to ensure all medicines are stored safely and securely.
• Review the practice’s audit protocols to ensure audits of various aspects of the service, such as radiography are undertaken at regular intervals to help improve the quality of service. Practice should also check that where applicable audits have documented learning points and the resulting improvements can be demonstrated.

Feedback from patients who used the dental service was extremely positive. Many described their experience at the service as ‘excellent’. Patients described staff as ‘respectful and wonderful’ and ‘very, very nice’. One person reported that the reception staff were ‘well-informed’. The service was clean and dental instruments were decontaminated and made safe for re-use.