We carried out an announced comprehensive inspection on 13 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Lyndhurst Dental Practice is a dental practice providing mainly private treatment and was established in 1975.

The practice is situated in a large detached Victorian villa occupying the ground floor and lower ground floor. Level disabled access is to the ground floor where there is one surgery. There is an external stairway to the lower ground floor where there are a further four surgeries. Off street parking is available and there are local bus and train links.

The practice employs four dentists, four dental hygienists, seven dental nurses and three reception staff. There were also staff employed for property maintenance, maintaining accounts and an administration assistant.

Several dentists have enhanced skills and provide more complex treatments such as dental implants, specialized gum treatments and complex root canal treatments.

The practice opens: Monday to Friday 8am 1pm and 2pm - 5.30pm. Saturday: Closed, Sunday: Closed.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. If patients called the practice when it was closed, an answerphone message gives the telephone number patients should ring depending on their symptoms.

One of the principal dentists 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.

The inspection was carried out by a lead inspector and a dental specialist adviser.

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 44 patients. In addition we spoke with two patients on the day of our inspection. Feedback from patients was positive about the quality of care, the caring nature of all staff and the overall high quality of customer care. They commented that staff put them at ease and listened to their concerns. They also reported they felt proposed treatments were fully explained them so they could make an informed decision which gave them confidence in the care provided.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Effective leadership was provided by the principal dentists.
• Staff had been trained to handle 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 effective and the practice followed published guidance.
• The practice had effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a policy and procedure in place for recording adverse incidents and accidents.
• The 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 had received training appropriate to their roles and were supported in their continued professional development (CPD) by the principal dentists.
• Staff we spoke with felt well supported by the principal dentists and were committed to providing a quality service to their patients.

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

• Review the dispensing protocols for the antibiotic amoxycillin in line with dispensing guidelines issued by the British Pharmacology Society.

We spoke with four patients, two dentists one of whom was the provider and five staff. Patients we spoke with were highly satisfied with their care and treatment. One patient told us "it's [the practice] amazing. Their [staff] manner are amazing. It doesn't feel stressful and they are good with children." Another patient said "I have has no trouble getting an appointment. I enjoy coming."

Patients we spoke with told they were well informed about their treatment and involved in their treatment decisions. Staff understood their legal responsibilities and obligations for enabling patient consent.

Overall staff told us they enjoyed working at the practice. The provider had processes in place to support staff effectively in their role. Staff attended essential training such as basic life support and safeguarding children and vulnerable adults. Nursing staff had access to online training to enable them to maintain their continuing professional development activities to meet the requirements of the General Dental Council.

The provider had a system which ensured patients' views on the service were listened and responded to. Information regarding making a complaint was readily accessible to patients.

Patients requiring further treatment or investigation were promptly and appropriately referred.

Practice equipment was well maintained and fit for purpose.

People we met at Lyndhurst Dental Practice were happy with their care and treatment. One patient said the service was "excellent" and said: "I can't fault it." Another patient told us: "I find it very good here. They are all very nice." People said they were given enough information to make their own decisions about care and treatment. We were told: "the patient is at the centre of this practice." One patient was relatively new to the practice and said they had chosen to come there from "good things heard about the dentists."

People said they were treated with privacy and dignity. They had not seen or overheard private or confidential information about other people using the practice. All conversations of a private nature were held in treatment rooms. People told us the dentists, dental nurses and hygienists told them what they were going to do when treating them. They were told what to expect following any treatment. Fees for treatment were explained prior to it commencing. People said they could get an appointment to suit them. Staff treated them with confidence and expertise.

We found the practice mostly clean although some less obvious areas required better attention. Decontamination was carried out in a dedicated room. This was done safely and regularly checked and monitored. Staff were well supported and had updated and ongoing training and development. The practice was assessed and monitored to ensure treatment was safe and effective.