We carried out an announced comprehensive inspection on 23 February 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 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

Middle Lane Dental is located in the London Borough of Haringey. The practice provides NHS and private dental treatment to both adults and children. The premises are on the basement and ground floor and consist of three treatment rooms, a reception area and a decontamination room. The practice is open Monday and Tuesday 9:00am – 8:00pm, Wednesday and Thursday 9:00am – 6:00pm, Friday 9:00am – 4:00pm and Saturday 10:00am – 2:00pm.

The staff consists of the principal dentist, four associate dentists, three dental hygienists, two dental nurses one of whom is the receptionist, and two trainee dental nurses.

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 34 CQC comment cards, the NHS Friends and Family test and the practice comments book. 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:

• There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.

• 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 the storage of records related to people employed and the management of regulated activities giving due regard to current legislation and guidance.
• Review the protocols and procedures for use of X-ray equipment giving due regard to guidance notes on the Safe use of X-ray Equipment.
• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting.

People told us they found the staff at this dental practice to be respectful and polite and none had had any concerns. They were extremely satisfied with their treatment. They said they had always found the environment to be clean. Comments included that it was, “fantastic, it’s clean. I’m very happy here” and “my whole family comes here, we are very satisfied.” One person described their dentist as “a miracle worker.”