We carried out an announced comprehensive inspection on 9 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

Nuffield House Dental Practice is situated within purpose adapted premises in Harlow, Essex. The practice has four treatment rooms and a combined waiting room and reception area. Decontamination takes place within a dedicated decontamination room (Decontamination is the process by which dirty and contaminated instruments are bought from the treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

The practice offers predominantly NHS and some private general and cosmetic dental treatments to adults and children.

The practice is registered with the Care Quality Commission (CQC) as an organisation. The principal dentist is the ‘registered manager’. 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.

In addition to the principal dentist, three associate dentists and six dental nurses work at the dental practice. The dental team are supported by two part time dental hygienists.

The practice is open and appointments are available from 9am to 5.30pm Mondays to Thursdays and between 8am and 4pm on Fridays.

We received feedback from 39 patients who completed CQC comment cards prior to our inspection visit. We also spoke with four patients during the inspection visit. Patients made positive comments about the quality of the dental care and treatment that they received. They also commented positively about the cleanliness of the premises, the friendliness and helpfulness of staff. Patients said that the dentists explained treatment plans to them in a way that they could easily understand. Patients told us that the dentists were kind and understanding particularly when treating anxious or nervous patients.

Our key findings were:

• The practice had systems in place for investigating and learning from complaints, safety incidents and accidents. Staff were aware of their responsibilities to report incidents.
• The practice was visibly clean and clutter free. Infection control practices were reviewed and audited to test their effectiveness.
• There were systems in place to help keep people safe, including safeguarding vulnerable children and adults. Staff had undertaken training and were aware of their roles and responsibilities in relation to this.
• Risks to the health, welfare and safety of patients and staff were regularly assessed and managed. These included risks in relation to fire, legionella and risks associated with premises and equipment.
• The practice reviewed and followed guidance in relation to dentistry.
• The practice had the recommended medicines and equipment for use in the event of a medical emergency and staff were trained in their use. Records were maintained in respect of the checks carried out for these medicines and equipment.
• Staff were recruited robustly, supported, supervised and undertook training in respect of their roles and responsibilities within the practice.
• Patients reported that they were treated with respect and that staff were polite and helpful.
• Patients were involved in making decisions about their care and treatments.
• Effective governance arrangements were in place for the smooth running of the service.
• Audits and reviews were carried out to monitor and improve services. Learning from audits and reviews was shared with relevant staff and action plans were developed to secure improvements where these were identified.
• Patient’s views were sought and these were used to make improvements to the service where these were identified.

During our inspection on 08 February 2013 we spoke with two people who used the service. They both said that the dentist had explained the treatment and the options for treatment available to them. One person told us, "They explained everything to me." One person said that they had telephoned the day before and had been offered an appointment for the following day. They told us, "The appointment time was very convenient. I could come before work so it had less impact on my day." The people we spoke with told us that they were very happy with the service that they had received. One person told us that the staff were, "Very nice and helpful."

The care and treatment plans contained records of all treatments that had been given. This included the date of the treatment, any advice given about after care and the date of any follow up that was required.

People were cared for in a clean, hygienic environment. During our inspection we saw that the practice premises were clean and bright. We spoke with three staff members. They all told us that they had an annual appraisal at which their professional development was discussed. The manager told us that the practice undertook quarterly surveys of people who used the service to identify their satisfaction levels and areas for improvement. We looked at the results of the survey that had taken place between 01 October 2012 and 31 December 2012. The results were generally positive.