We carried out an announced comprehensive inspection on 7 March 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

St Cross Road Dental Practice is a dental practice providing NHS and private treatment for both adults and children. The practice is based in Winchester, Hampshire.

The practice has two dental treatment rooms which are based on the first floor of a grade II listed building and a separate decontamination room used for cleaning, sterilising and packing dental instruments. Patients with limited mobility are sign-posted to nearby dental services with ground floor access.

The practice employs two dentists, two hygienists, one nurse and a practice manager who also covers reception.

The practice’s opening hours are between 8am and 5pm from Monday to Thursday and 8am to 1pm on Friday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by the principal dentist and an out-of-hours service, via 111.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual and is legally responsible for making sure that the practice meets the requirements relating to safety and quality of care, as specified in the regulations associated with the Health and Social Care Act 2008.

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 26 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.

We obtained the views of three patients on the day of our inspection.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Effective leadership was provided by the practice owner and an empowered practice manager.
• 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.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Infection control procedures were effective 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.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
• 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 received training appropriate to their roles and were supported in their continued professional development (CPD) by the company.
• Staff we spoke with felt well supported by the practice owner and were committed to providing a quality service to their patients.
• Patient feedback before and during our inspection gave us a completely positive picture of a friendly, caring, professional and high quality service.

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

• Review the availability of hearing loops for patients who are hard of hearing.
• Review display of information related to staff working at the practice taking into account guidance issued by the General Dental Council.
• Review the protocols with respect to the validation of ultrasonic cleaning bath to include a weekly residual protein test.

• Review the risks in relation to fire safety and carbon monoxide so risks are fully identified and mitigated.

• Review the arrangements for the appraisal of practice staff.

• Review the procedures with respect to the recruitment of staff so that the proof of identity, eligibility to work in the UK and induction is recorded and retained in the employees recruitment file.

We spoke with eight people about their care and treatment. Everybody told us that they had discussions with their dentist about the treatment they needed. One person told us, “My dentist explained the different types of denture that were available and how much each would cost. I was then able to make my own mind up.”

All those we spoke with were complimentary about the care they received. Patient records enabled us to see the information recorded at each person’s visit. People we spoke with confirmed they had their treatment plan explained to them and that they received a written copy. One person told us "They know I am nervous they are good at reassuring me."

Staff were able to demonstrate that they were aware of the safe practices required to meet essential standards. They also described the checks they carried out to check that decontamination equipment was functioning properly. People we spoke with told us that staff wore gloves and masks whilst providing their treatment.

The provider had ensured that all staff took part in an annual appraisal. This gave staff the opportunity to discuss their training and personal development needs.

People commented on the welcoming friendly atmosphere at the practice, one person said "It's nice to have a happy dentist."

We heard the practice manager asking each person before they left how their appointment had been that day. This gave people the opportunity to comment about their care and treatment.