We carried out an announced comprehensive inspection on 6 December 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

Purfleet Dental Suite is a dental practice situated within purpose built NHS managed health centre in Purfleet, Essex. The practice has two treatment rooms and a combined waiting room and reception area. Decontamination takes place within a dedicated decontamination room (Decontamination is the process by which dirty and contaminated instruments are bought from the

treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

The practice offers predominantly NHS and some private general and cosmetic dental treatments to adults and children.

The practice is open and appointments are available from 9.30am to 12.30pm and 1pm to 4pm Mondays to Thursdays. The practice is closed on Fridays.

The practice has two dentists, three dental nurses and one receptionist.

The practice is registered with the Care Quality Commission (CQC) as an individual. The practice manager is the ‘registered person’. 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.

We received feedback from 15 patients who completed CQC comment cards prior to our inspection visit. We also spoke with six patients during the inspection visit. Patients made positive comments about the quality of the dental care and treatment that they received. They also commented positively about the cleanliness of the premises, the friendliness and helpfulness of staff. Patients said that the dentists explained treatment plans to them in a way that they could easily understand.

Our key findings were:

• The practice had systems in place for investigating and learning from complaints, safety incidents and accidents. Staff were aware of their responsibilities to report incidents.
• The practice was visibly clean and clutter free. Infection control practices were reviewed and audited to test their effectiveness.
• There were systems in place to help keep people safe, including safeguarding vulnerable children and adults. Staff had undertaken training and were aware of their roles and responsibilities in relation to this.
• Risks to the health, welfare and safety of patients and staff were regularly assessed and managed. These included risks in relation to fire, legionella and risks associated with premises and equipment.
• The practice reviewed and followed guidance in relation to dentistry. However we found that dentists did not routinely use a rubber dam as recommended to protect patient’s airways when carrying out root canal treatment.
• The practice had the recommended medicines and equipment for use in the event of a medical emergency and staff were trained in their use. Records were maintained in respect of the checks carried out for these medicines and equipment.
• Staff were recruited robustly, supported, supervised and undertook training in respect of their roles and responsibilities within the practice.
• Patients reported that they were treated with respect and that staff were polite and helpful.
• Patients were involved in making decisions about their care and treatments.
• Effective governance arrangements were in place for the smooth running of the service.
• Audits and reviews were carried out to monitor and improve services. Learning from audits and reviews was shared with relevant staff and action plans were developed to secure improvements where these were identified.
• Patient’s views were sought and these were used to make improvements to the service where these were identified.

There was an where the provider could make improvements and should:

• 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.

At the time of our inspection the surgery was closed to service users and so we were unable to obtain their views on the day. We looked for other ways in which the provider obtained feedback but we were told that no satisfaction surveys were carried out and that no suggestion box was used. Apart from having a complaints procedure in place, the provider did not have any systems in place to obtain views or encourage people to express their views about the service.