We carried out an announced comprehensive inspection on 7 November 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.

Pembroke Dental Practice and Implant Centre is a predominantly NHS practice on a purpose built housing estate near Crawley town centre, West Sussex. The practice offers a range of general dental treatment. The premises are located on the ground floor and consist of four dental treatment rooms, a reception and waiting area and a separate decontamination area.

The staff at the practice consist of two principal dentists, two associate dentists, a dental hygienist and five trainee dental nurses (some of whom also cover reception duties).

One of the principal dentists 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.

Our key findings were:

• There was an induction programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers and the X-ray equipment.

• We found the dentists regularly assessed each patient’s gum health and the dentist took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• The practice placed an emphasis on the promotion of oral and general health and the prevention of dental disease. Appropriate information and advice was available according to patients’ individual needs.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received comprehensive assessments of their oral health needs. They were given clear explanations about their proposed treatment, and its costs, benefits and risks and were involved in making decisions about it.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were kind, caring, very welcoming and worked well as a team.

• There was an effective system in place to act on feedback received from patients and staff.

• We reviewed 46 Care Quality Commission (CQC) comment cards that had been completed by patients prior to our inspection. Common themes were patients felt they received excellent care in a calm and hygienic environment from staff who were caring, polite and informative.

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

• Review availability of medicines and equipment 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 audit protocol of infection prevention and control measures to ensure this is undertaken every six months in line with current guidance.

We spoke with four patients, two dentists, four dental nurses and the practice manager. Patients spoke positively about their experiences at the service. Their comments included, “I can relax when I visit as I am safe in the knowledge that they are professionals and know what is best for my teeth and I have confidence in them, that I always follow their advice” and “I have never had any problems, you sometimes have to wait past your appointment time.“

Patients were involved in decisions about their dental care and were consulted about their treatment plans. Patient confirmed that their dentist had talked through options and discussed and agreed their treatment plans. Patients told us, “I recall discussing what my treatment options were and had the opportunity to talk these through with the dentist” and “Although I am an NHS patient the dentist has talked to me about what my best options would be and I was able to ask questions and then finally I agreed which option would be best for me.”

All patients spoke positively about staff who they described as, “Helpful” and “Professional.” A patient said, “All the staff seem very friendly there is one nurse who is really funny and they always make me laugh.” All staff consulted with spoke knowledgeably about their specific roles and responsibilities.

Patient comments regarding standards of cleanliness include,: “Always very clean” and “Spotless.” Staff received appropriate training and professional development to ensure they continued to have the skills needed to provide good quality and safe treatments.

Patients told us that they were very happy with the services that they received and as such had never had any cause to complain. Patients said that if they were however dissatisfied then they felt confident that they could raise any issues directly with the dentist.