We carried out an announced comprehensive inspection on 15 June 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

Park Lane Dental is a dental surgery located in Croydon and provides a mixture of NHS and private dental services. The demographics of the local area were mixed and the practice served patients from a range of social, economic and ethnic backgrounds.

The practice staffing consists of seven dentists (including five associates), four dental nurses, three receptionists, two hygienists and reception and administration staff.

The practice is open from 9.00am to 5.30pm Monday to Fridays. The practice is set out over two floors with four surgeries. There is step free access to the building. There is no lift to the first floor however patients with mobility issues are accommodated in one of the ground floor surgeries. There is a wheelchair accessible toilet. Other facilities include staff rooms/ kitchen, X-ray room, stock room, decontamination room and reception area.

One of the partners 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 took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

We received feedback from 18 patients. Patient feedback was very positive about the service. They were also complimentary about the staff stating they were polite and courteous and provided a customer focussed service. Patients stated that the premises were always clean and tidy when they attended.

Our key findings were:

• Systems were in place for the provider to receive safety alerts from external organisations and they were shared appropriately with staff.
• Processes were in place for staff to learn from incidents and lessons learnt were discussed amongst staff.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were decontaminated suitably.
• Patients’ needs were assessed and care was planned in line with current guidance.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Staff had access to an automated external defibrillator (AED) and medical oxygen although not all staff had received recent training.
• There were policies and procedures in place to staff to follow relating to safeguarding patients from abuse.
• All clinical staff were up to date with their continuing professional development.
• The practice was carrying out risk assessments regularly.

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

• Review availability of staff training 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 practice’s safeguarding policy and staffs training ensuring it covers both children and adults and all staff are trained to an appropriate level for their role and are aware of their responsibilities.
• Review the current Legionella risk assessment and implement the required actions taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.
• Review the practice's recruitment policy and procedures to ensure character references for new staff as well as proof of identification are requested and recorded suitably.
• Review its current audit protocols to ensure audits of key aspects of service delivery are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.

On the day of the inspection we spoke with four people who used the service. They told us that they were usually seen punctually at their appointment time. They said that the costs and possible treatment options were explained to them at their appointments. One person told us, “I am pleased with my treatment here." Another commented "I have been coming here for a long time, I used to hate going to the dentist but it’s ok here."

We looked at some of the surgery records. We saw people had treatment plans which took into account their relevant medical history, explained their treatment needs and possible options. Advice was given when needed and costs were recorded and provided to patients.

We saw that the practice had infection control systems in place. Three people we spoke with said that they had been coming for a long time and they felt the practice was always clean. People said they felt confident in the dental care provided and some had recommended it to their family or friends.

We spoke with staff and looked at staff records and saw that staff had regular training. We looked at other practice records and found that the provider undertook regular infection control audits to monitor and review the quality and safety of the service provided. Feedback from patients was used to try and make any improvements to the service.