We carried out an announced comprehensive inspection on 06 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

Rectory House Dental Practice is located on the junction of Hunter road and Epsom Road in Guildford, Surrey. At the entrance of the practice there are four concrete steps that are not suitable for people using wheelchairs. The practice resides over three levels including the basement. There are three treatment rooms, a decontamination room, an X-ray room, two waiting rooms and a spacious reception area. Parking is available at the rear of the practice and local streets have pay and display. The premises are not suitable for patients using wheelchairs.

The practice provides NHS and private services to adults and children. As well as general dental services the practice provides specialist services for orthodontics and prosthodontics. Orthodontic treatment is provided on a referral basis under NHS regulations for children except when the problem falls below the accepted eligibility criteria for NHS treatment. Private treatment is available for these patients as well as adults who require orthodontic treatment.

The practice staffing consisted of six dentists (including the two partners that own the practice), two dental hygienists, four dental nurses and three receptionists.

The practice opening hours are Monday to Friday 8:30am to 5pm.

One of the principal dentists is registered with the Care Quality Commission (CQC) as an individual. 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 inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Before the inspection we sent Care Quality Commission (CQC) comments cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 46 patients provided feedback about the service. All comments were positive about 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:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the British Orthodontic Society and National Institute for Health and Care Excellence (NICE).
• The practice had an ongoing programme of risk assessments and audits which were used to drive improvement.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients commented that the team were friendly, caring and provided a pain free service.
• Dentists and hygienists were up to date with their continuing professional development.
• There was a comprehensive induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.
• Staff recruitment files were organised and complete.
• Staff we spoke with felt well supported by the management team and were committed to providing a quality service to their patients.
• Feedback from patients gave us a positive picture of a friendly, caring, professional and high quality service.

During our inspection we spoke with four young people who had attended for appointments at the orthodontic service together with their parents. We also spoke with the registered manager and five members of staff.

People who used the service made positive comments about the care and treatment they received at Rectory House Dental Practice. Comments they made to us included, “The dentist is really good. He really understands my case” and “The treatment is good. I really like the dentist”.

All the people we spoke with told us they had received good information about any proposed treatment. We were told the dentists always ensured they sought consent from both the young person and their parents before they made the decision to proceed with treatment.

We found there were appropriate arrangements in place to ensure medicines were handled safely.

All the staff we spoke with told us they enjoyed working at the practice. They commented, “It’s a good working team” and “I like working here. I enjoy orthodontics; it’s a satisfying job”.

The provider had systems in place to monitor the quality of service provision. We found people's views had been taken into account in the way the service was provided.

We spoke with several adults and children during our visit and all of the people we spoke with told us that they were very happy with the treatment and services provided.