We carried out an announced comprehensive inspection on 6 May 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

Ponders End Dentistery located in Enfield provides NHS and private dental treatment to patients of all ages.

Practice staffing consists of the registered manager, five associate dentists, one hygienist, four dental nurses, two receptionist/dental nurses and one receptionist/manager.

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

The practice facilities include four treatment rooms, reception and waiting area, decontamination room, two offices and a staff room/kitchen.

34 patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received about the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• There were systems in place to ensure that all equipment was maintained in line with manufacturer’s guidelines.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• The practice ensured staff were trained and that they maintained the necessary skills and competence to support the needs of patients.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
• Patients received clear explanations about their proposed treatment, 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.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical and non-clinical audits were carried out to monitor the quality of services.
• The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.

Patients told us that treatment was explained to them by staff in the surgery in private, that they were given choices of treatment, were able to express their views and were involved in making decisions about their care and treatment. One patient told us that "good information was provided and I was given costs and options."

We spoke with staff and saw records that showed care and treatment was planned and delivered in line with their individual treatment plan. Patients were recalled at intervals based on their individual needs. One patient said, "the dentist is very professional."

Staff were aware of patient safety and child protection policies and procedures and knew to report any allegations of abuse to the manager, the local authority and police as necessary.

The premises were clean and well maintained. The practice had recently been refurbished and one patient comment was “all the changes are very pleasant and the practice looks clean”. We saw that audits had been carried out by the provider to monitor infection control guidelines as detailed in Department of Health Technical Memorandum 01-05 (HTM 01-05).

We saw that patients' personal records including medical records were stored securely and were kept up to date. Records were retained and stored in accordance with the Data Protection Act 1998.