We carried out an announced comprehensive inspection on 7 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 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

Peartree Dental Practice is a general dental practice close to the centre of Welwyn Garden City in Hertfordshire.

The practice has two treatment rooms and offers general dental treatment to adults and children funded by the NHS or privately. The practice offers dental implants privately. A dental implant is a metal post that is placed surgically into the jaw bone; one or more can be used to support a tooth or teeth.

The practice now has one principal dentist, two associate dentists and one locum dental hygienist, supported by three qualified dental nurses and a practice manager. Reception duties are covered by the dental nurses and practice manager.

The practice is open from 9 am to 5.30 pm on Monday to Friday.

The practice is not fully accessible to wheelchair users. There is a downstairs treatment room where patients with limited mobility are accommodated. The toilet facilities are not wheelchair accessible, and although there is a ramp to the front door there is still a lip at the threshold that wheelchair users would have to negotiate to gain access.

The practice owner is registered with the Care Quality Commission (CQC) as an individual. 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 Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience. We received feedback from 20 patients. These provided a positive view of the services the practice provides. Patients commented on the quality of care, the polite and friendly nature of staff and the cleanliness of the practice.

Our key findings were:

• The practice was visibly clean and clutter free.

• Comments from patients indicated that the staff were kind and caring and were skilled at putting nervous patients at ease.

• The practice met the standards set out in national guidance regarding infection control.

• A routine appointment could be secured within a couple of weeks and emergency appointments would be arranged where possible on the day they contacted the service.

• The practice had policies in place to assist in the smooth running of the service.

• The practice had medicines and equipment to treat medical emergencies.

• Dentists at the practice used national guidance and standards in the care and treatment of patients.

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

• Governance arrangements were in place for the smooth running of the service.

• Appropriate pre-employment checks were being carried out to ensure the service employed fit and proper persons.

• The practice was not logging prescriptions pads in line with national guidance.

• The practice was not including all required information on labels when dispensing medicines.

• The clinicians were not always using rubber dam when completing root canal treatment.

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

• Review the practice protocols regarding records of prescription forms with reference to the NHS guidance on security of prescription forms August 2013.

• Review the labelling of medicines that are dispensed giving due regard to schedule 26 of the Human Medicines Regulations 2012.

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.