We carried out this announced inspection on 02 August 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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 Faiths Clinic is in East Grinstead, West Sussex. The practice provides private dental treatment and holds NHS contracts to provide dental treatment under conscious sedation, to patients of all ages.

The practice is accessible for pushchairs and wheelchairs. Car parking spaces including those for blue badge holders are available onsite.

The dental team includes the clinical director/oral surgeon, six dentists, one dental hygiene therapist, six dental nurses who perform dual roles on reception, four receptionists and a practice manager who is a qualified dental nurse. The practice also has an endodontist, a periodontologist, a consultant paedodontist and a consultant orthodontist. Additionally, there are four visiting anaesthetists. The practice has four treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at St Faiths Clinic is the practice manager.

On the day of inspection, we collected feedback from 17 patients.

During the inspection we spoke with the clinical director, one dentist, three dental nurses, three receptionists and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Friday from 8.30am to 5pm
• Saturdays and late appointments by arrangement only

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported; and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

We carried out an announced comprehensive inspection on 3 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

St Faiths clinic is an independent dental practice with NHS contracts for specialist treatment on referral. It provides general dentistry and also specialises in providing complex treatment for patients such as oral surgery and nervous patients including those with significant anxieties about having dental treatment. The practice caters for children and adults.

The practice has four dental treatment rooms, a decontamination room for cleaning, sterilising and packaging of dental instruments. There is a reception area and waiting room on the ground floor and another waiting area upstairs on the first floor.

The practice has seven dentists, one of which is an oral surgeon, five registered dental nurses and one student dental nurse. One dental hygienist provides preventative advice and gum treatments on prescription from the dentists working in the practice. The practice also uses specialist input from three anaesthetists and four visiting specialists offering complex services for endodontics (root canal), periodontics (gums), orthodontics and paedodontics (children).

The practice also accepts referrals for computerised tomography (CT) scans which provide detailed three dimensional images of the head (including teeth and other oral structures).

The practice manager and clinical team are supported by an administrator, a filing clerk and two receptionists.

The provider is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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 use to tell us about their experience of the practice. We collected 22 completed cards. These provided a positive view of the service the practice provides. We also spoke with five patients. Patients were complimentary about the friendliness and professionalism of staff, the care and treatment they received and the standards of cleanliness at the practice. One comment stated that the service was very good but sometimes it was difficult to get an appointment.

Our key findings were:

• Staff reported incidents and kept records of these which the practice used for shared learning.

• The practice was visibly clean and well maintained.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• The practice had effective safeguarding processes and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.

• The practice specialised in supporting nervous patients to overcome their anxieties about having dental treatment. Patients were particularly appreciative of the care and understanding they were shown.

• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).

• The practice provided the option of sedation to patients and carried this out in line with guidelines from the Society for the Advancement of Anaesthesia in Dentistry (SAAD)

• The practice had a written sedation and discharge protocol which was followed by staff.

• The practice took into account any comments, concerns or complaints and used these to help them improve the practice.