We carried out an announced comprehensive inspection on 24 February 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

The S3 Dental Eltham practice is located in the London Borough of Greenwich. The premises are situated in a converted residential building. There are four treatment rooms, a decontamination room, an X-ray room, a waiting room, a staff room and a patient toilet on the ground floor of the building.

The practice provides NHS and private services to adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers and crowns and bridges. There is also a visiting doctor who provides oral surgery services.

The staff structure of the practice consists of a principal dentist, five associate dentists, a trainee dentist, five dental nurses, a practice manager, and three receptionists.

The practice opening hours are on Mondays to Thursdays from 8.00am to 8.00pm and on Fridays from 8.00am to 5.00pm. The practice is open on alternate Saturdays.

The principal dentist 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.

Eight people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

• There were effective systems 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 children living in vulnerable circumstances.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• There were effective arrangements in place for managing medical emergencies.
• 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 indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Governance arrangements and audits were effective in improving the quality and safety of the services. We identified some areas where risk management processes, for example, in relation to the management of staff recruitment checks, could be improved. The practice sent us evidence, after the inspection, to demonstrate that they had taken action to address these issues.

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

• Review the storage of dental care products and medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.
• Review the current Legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance
• Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal reference taken and ensuring recruitment checks, including references, are suitably obtained and recorded.

The people we spoke with had recently received treatment from the dentist. People told us that they were happy with the treatment they received at S3 Dental Eltham. One person told us that the service was “brilliant” and “I cannot fault it”. Another person told us the staff were “understanding”, “great”, “polite” and made people who were anxious feel relaxed. People told us that they were given choices and their decisions were respected. People said their privacy and dignity was maintained and they felt the surgery was visibly clean.

We found that people were given enough information to allow them make informed decisions about their treatment. People who use the service had a care plan in place and were involved in planning their care. Staff knew about their responsibility to identify and report abuse. We found the provider followed relevant infection control protocols including appropriate processes for the decontamination of instruments. Staff were supported through induction, training, appraisals and team meetings.