People told us that they were happy with the service provided. They felt they were given enough information about their treatment options and the relevant fees and they had opportunity to ask questions.

People said the clinic was clean and the staff were friendly and knowledgeable.

We carried out an announced comprehensive inspection on 19 January 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

Prestwood Dental Health Centre is a dental practice providing NHS and private treatment for both adults and children. The practice is based in a converted domestic dwelling in Great Missenden, a town situated in Buckinghamshire.

The practice has three dental treatment rooms two of which are based on the ground floor. The cleaning, sterilising and packing of dental instruments takes place within a designated area each dental treatment room. The ground floor is accessible to wheelchair users, prams and patients with limited mobility.

The practice employs three dentists, one hygienist, one dental therapist, two dental nurses, one trainee dental nurse and a receptionist.

The practice’s opening hours are between 8.30am and 5pm Monday to Thursday and 8.30am and 1pm on Friday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an emergency service with each of the dentists taking it in turn to be on call.

Dr Amit Majevadia, the practice owner, is registered as an individual and is legally responsible for making sure that the practice meets the requirements relating to safety and quality of care, as specified in the regulations associated with the Health and Social Care Act 2008.

We obtained the views of eight patients on the day of our inspection.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Leadership was provided by the practice owner.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Infection control procedures were effective and the practice followed published guidance.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice owner.
• Staff we spoke with felt well supported by the practice owner and was committed to providing a quality service to their patients.
• Information from nine completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

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

• Review the systems with respect to fire; including risk assessment for fire and safety criteria relating to fire safety including; fire training, emergency lighting, fire alarms, fire drills and fire signage.
• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013. Specifically, the addition of a risk assessment and a description of the protocol used for the recapping of needles following the administration of a local anaesthetic in the practice’s sharps policy.
• Review the monitoring frequency of the emergency oxygen and automated external defibrillator so that they are reviewed at least weekly rather than on the existing monthly arrangements.
• Review the expiry date of the emergency medicine glucagon to reflect the fact that the glucagon is stored outside of a refrigerator.
• Consider the provision of an external name plate providing details of the dentists working at the practice including their General Dental Council (GDC) registration number in accordance with GDC guidance issued in March 2012. This should also include practice information leaflets and the practice website.
• Review the availability of hearing loops for patients who are hard of hearing.
• Review the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure they are stored securely.
• Consider providing the hygienist with the support of an appropriately trained member of the dental team.
• Review the storage arrangements for clinical and domestic waste.
• Consider the addition of a referral protocol and tracking system to support the existing system for working with other services.
• Review the contents of the accident book, specifically removal of pages containing previous accidents to protect the identity of patients and staff.