We carried out an announced comprehensive inspection on 17 March 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

Surrey Dental Specialists is located in Dorking, Surrey. The premises are situated off the High Street in Allen Court. There is a pay and display car park close to the practice for staff and patients. There are two treatment rooms, a reception and waiting area, a decontamination room, an office and a toilet with disabled facilities. The practice resides on one level giving access for patients using a wheelchair or mobility scooter.

The practice provides private specialist dental services to adults. Patients are accepted through referrals from local dental services providing general dental care. The specialist dental services provided are Periodontology (treating gum disease), Endodontology (root canal treatment) and Prosthodontology (replacing missing teeth for example with a bridge or implant).

The practice staffing consists of four specialist dentists that are registered as specialists with the General Dental Council (GDC). This includes the principal dentist who is also the provider and practice manager. The team has a dental hygienist and three dental nurses that are also trained to work on reception when required.

The practice is open 8:00am to 4:00pm Monday, 8:00am to 6:00pm Tuesday and Wednesday, 9:00am to 6:00pm Thursday and 8:00am to 2:00pm Friday.

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.

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 31 patients about the service. All the comments from the patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff and commented on the high quality of customer care they received.

Our key findings were

• Practice ethos was to provide high quality care with successful outcomes.
• Strong and effective clinical leadership was provided by the provider.
• The practice benefitted from a stable staff base and an empowered team.
• Information from 31 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice was clean and well maintained.
• Infection control procedures were robust 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.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• Patients could access treatment and urgent and emergency care when required.
• Staff recruitment files were organised and complete.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the provider.
• Staff we spoke to felt well supported by the provider and were committed to providing quality service to their patients.
• Governance arrangements and audits were effective in improving the quality and safety of the services.

As part of our inspection we spoke with three patients and the relative of one patient about the treatment and service they received. They told us that they were happy with the service. One patient said "Can't fault it" and "I'm very impressed with it here".

We looked at the medical records for four patients. The records contained up to date medical histories and treatment plans for each patient. Treatment plans clearly described the different options and associated costs. The patients we spoke with all confirmed that the costs for their consultation and treatment had been fully explained.

We spoke with staff who were able to clearly explain their role with regards to safeguarding vulnerable adults and children. They said they would feel confident in reporting safeguarding concerns so that the appropriate action would be taken.

On the day of our inspection we saw that the practice was clean and tidy. The service had appropriate policies in place to manage infection control and good infection control procedures were followed.

Patients and their representatives were asked for their views about the service. We saw that the practice offered patients a variety of ways to provide feedback which included patient feedback questionnaires and a suggestions box in the reception area. The feedback from patients was reviewed and considered monthly by the principle dentist in order to improve the service provided.