We carried out an announced comprehensive inspection on 21 December 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

E. Lazanakis Limited is a company providing private dental and NHS treatment for both adults and children. The company provide dental care at three locations across Sussex. The practice inspected is called Old Village Dental Centre and is based in a converted house in Portslade, East Sussex which is situated close to a bus stop. The practice is on two floors with two dental treatment rooms on the top floor and one on the ground floor. There is no separate decontamination facility used for cleaning, sterilising and packing dental instruments. The practice has ground floor access to wheelchair users, prams and patients with limited mobility. The practice employs five dentist, two hygienists, five dental nurses, one trainee dental nurse and two receptionists. The practice’s opening hours are Monday, 09.00 to 19.00 and Tuesday through to Friday, 9.00am to 5.00pm. The practice is closed for lunch from 13.00 to 14.00 daily.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. This is provided by the urgent care centres.

Dr Emmanuel Lazanakisis is the principle dentist and the nominated individual for the company. Dr Emmanuel Lazanakisis and Ms Anna Kalusinska are joint registered managers for this practice. 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. The nominated individual must be employed as a director, manager or secretary of the organisation (i.e. they should be a senior person, with authority to speak on behalf of the organisation). They must also be in a position which carries responsibility for supervising the management of the carrying on of the dental practice (i.e. they must be in a position to speak, authoritatively, on behalf of the organisation, about the way that the service is provided.

Dr Emmanuel Lazanakisis was away at the time of the inspection. Ms Anna Kalusinska was present and assisted with the inspection process.

We spoke with three patients on the day of our inspection and reviewed 50 comment cards that had been completed by patients. Common themes were patients overall were satisfied with the friendly and caring treatment they had received. We also noted a number of comment cards which described how nervous, anxious or vulnerable patients were treated and the extra care the practice gave to ensure they were given extra time and reassurance.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.

• Leadership was provided by the principle dentist who was also the registered 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 of a high standard and the practice followed published guidance.

• The registered manager acted as the safeguarding lead with effective processes for safeguarding adults and children living in vulnerable circumstances.

• There was a process 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 practice owner.

• Staff we spoke with felt very well supported by the practice owner and was committed to providing a quality service to their patients.

•Patients told us through comment cards they were treated with kindness and respect by staff. The practice did always ensure there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.

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

• Review the practice's staff files so that staff files are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, specifically by ensuring that evidence is provided for check that all staff recruitment files are complete, particularly with regards to references, interview notes and evidence of employers decision to decide whether to accept a previously-issued DBS check. There should also be evidence for all staff of CPD and any training undertaken which impacts on the practice.

• Implement a way of recording the staff who have attended training in how to deal with a fire and those who have not attended practice fire drills.

• The practice should consider if it should review and develop audits of clinical practice and the recording in patients notes. This should include if basic periodontal examination (BPE) scores and soft tissues lining the mouth are being undertaken and recorded.