We carried out an announced comprehensive inspection on 22 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

Background

Purley Dental Care is a mixed dental practice providing mainly NHS treatment. The practice is situated in a converted residential property. The practice had four dental treatment rooms two separate decontamination rooms for cleaning, sterilising and packing dental instruments, two patient waiting rooms, a staff room and administration office.

The practice is open 8.30am – 8.30pm Monday and Thursday; 8.30am to 5.30pm Tuesday, Wednesday and Fridays. The practice has four dentists working over the course of a week who are supported by three dental nurses, two dental hygienists and three receptionists.

The principal dentist 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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 15 patients. These provided a completely positive view of the services the practice provides. Patients commented on the high quality of care, the caring nature of all staff, the cleanliness of the practice and the overall high quality of customer care.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Strong and effective leadership was provided by the practice owner.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Infection control procedures were robust 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.
• The practice had a system in place for reporting incidents which the practice used for shared learning.
• 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 recruitment files were organised and complete.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice owners and practice manager.
• Staff we spoke with felt well supported by the practice owner and practice manager and were committed to providing a quality service to their patients.
• Information from 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 practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

Following our last inspection to the service in November 2012, we identified essential standards of quality and safety were not being met in respect of Regulation 10 and Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We asked the provider to take appropriate action to achieve compliance with these regulations.

We did not speak to people using the service during our visit. We gathered evidence of people’s experiences of the service by speaking with staff and reviewing other records related to the running of the service.

The registered manager showed us the changes that had been made since our last inspection. We saw the service had reviewed and updated its infection control policy and rolled out cleanliness and infection control training to staff working at the practice. A new decontamination room had been built and new polices and procedures for the cleaning, inspection, sterilisation and storage of instruments had been implemented.

The general environment was clean and tidy. Hand washing sinks were readily available with guidance about good hand washing techniques clearly displayed.

We saw the service had introduced an effective system to audit, monitor and review the practice’s system, process and procedures. We noted learning from these checks had been used to make improvements and changes.

People we spoke with who use the service were positive about the care and treatment they had received. People told us staff were ‘nice’ ‘friendly’ and ‘efficient’. One person told us about the care shown to their relative who had undergone extensive treatments. They told us staff had been ‘fantastic’ in this instance.

The current provider, who is also the registered manager and principal dentist, took over the practice in June 2012. The provider has undertaken a programme of refurbishment since taking over the practice. People we spoke with told us they had noticed the changes and they liked these. All the people we spoke with felt the environment was clean and well maintained.

Although people using the service were positive about the cleanliness of the environment during the course of our inspection we identified a number of concerns about cleanliness and infection control within the practice. People were being put at risk of acquiring infections due to poor standards of cleanliness and infection control within the practice.