We carried out an announced comprehensive inspection on 6 December 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

Norfolk Street Dental Surgery is a well-established dental practice that provides primarily NHS treatment to children and adults. The team consists of one dentist, one dental nurse and two receptionists. The practice is situated in a small row of shops and has one dental treatment room, a decontamination room, and a waiting and reception area.

The practice opens from 9am to 5pmon Monday to Fridays and is closed for lunch between 1pm and 2pm.

The practice owner is registered with the Care Quality Commission (CQC) 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.

Before the inspection we sent comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 44 patients who commented positively about the quality of the service and the effectiveness of their treatment.

Our key findings were:

• We received consistently good feedback from patients about the caring and empathetic nature of the dentist, and the effectiveness of their treatment.

• There were sufficient numbers of suitably qualified and competent staff. Members of the dental team were up-to-date with their continuing professional development and supported to meet the requirements of their professional registration.

• Appointments were easy to book and emergency slots were available each day for patients requiring urgent treatment.

• Patients’ care and treatment was planned and delivered in line with evidence-based guidelines, best practice and current legislation. Patients received clear explanations about their proposed treatment and were actively involved in making decisions about it.

• The practice listened to its patients and staff and acted upon their feedback.

• Staff did not receive regular appraisal of their performance and there were no regular minuted staff team minutes.

• Risk assessment was limited, and polices were not kept up to date or made relevant for the practice.

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

•  Ensure all unusual events are recorded to aid learning should an incident occur in the future
• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
• Review the practice's recruitment procedures to ensure photographic proof of identification is requested, the need for a DBS check is risk assessed and notes of interviews are formally recorded.

• Review the practice’s policies to ensure they are relevant, up to date and discussed with staff.

• Implement an effective process for the on-going assessment and appraisal of all staff employed.

During our inspection we spoke with five people who were attending the surgery for treatment. Each person made very positive comments about the quality of the care and treatment they had experienced. One person said, "I cannot fault the dentist. I have been coming here for a number of years and see no reason to change my dentist". Another person said, "I am more than happy to come to this dentist for treatment".

Care plans kept of each person’s treatment indicated they had made choices about their treatment and this was confirmed by what people told us.

Infection control was satisfactorily managed and conformed to the essential standards set out in the Department of Health's published guidance for dentists.

We saw that improvements had been made to the safeguarding arrangements the surgery had taken to ensure that children and vulnerable adults were protected from abuse.

There was information available to people in the surgery about making a compliant and how the surgery would appropriately manage any compliant they might receive.

People told us that they were satisfied with their care and treatment whenever they had attended the surgery. We spoke to people whose families also received dental care from the practice and they confirmed they were also satisfied with the standard of care they had received.

People told us they felt safe when visiting the dentist and they told us they had been given enough information for them to make choices and decisions about their treatment.