We carried out an announced comprehensive inspection on 18 August 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.

Regency House Dental Practice is a private dental practice in central St Albans, Hertfordshire. The practice offers a range of general dental treatment as well as implants and some orthodontic treatment. The practice also offers conscious sedation to patients who may be very anxious. The premises are located above retail premises on the first floor and consist of a dental treatment room and a waiting area. There is also a designated decontamination room on the second floor.

The staff at the practice consists of two principal dentists, an associate dentist and a dental nurse who also undertakes administrative duties relating to the management of the practice.

One of the principal dentists 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.

Our key findings were:

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment room and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers and the X-ray equipment.

• Conscious sedation was delivered safely in accordance with current guidelines.

• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• Appropriate information and advice was available according to patients’ individual needs.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received comprehensive assessments of their oral health needs. They were given clear explanations about their proposed treatment, and its 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.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were kind, caring, and welcoming.

• There was an effective system in place to act on feedback received from patients and staff.

• We reviewed 17 Care Quality Commission (CQC) comment cards that had been completed by patients prior to our inspection. Common themes were patients felt they received a caring and professional service from friendly staff in a calm environment.

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

• Review the practice’s fire safety procedures to ensure an effective system is in place to assess, monitor and mitigate the risks to patients, staff and visitors.

• Review the practice’s safeguarding policy ensuring it covers local safeguarding arrangements.

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.

• Review staff training to ensure that dental nursing staff who are assisting in conscious sedation have the appropriate training and skills to carry out the role.

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).

• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.