We carried out an announced comprehensive inspection on 17 October 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

The Forum Dental Studio is a mixed dental practice providing mainly private and some NHS dental care for both adults and children. Where private treatment is provided, some is provided under a fee per item basis and some under a dental insurance plan. The practice holds NHS contracts for the provision of orthodontic treatment for children and minor oral surgery on a referral basis only. The premises in which the practice is situated is a two storey purpose built facility but with all patient services available on the ground floor.

The practice has four dental treatment rooms, all on the ground floor. There is a separate decontamination room used for cleaning, sterilising and packing dental instruments and X-ray room. There is also a reception, divided waiting area and other rooms used by the practice for office facilities and storage. The practice is open from 8.30am to 5.15pm on Mondays to Thursdays and 8.30am to 4.30pm on Fridays.

The practice has five dentists who are able to provide services including the provision of dental implants (a dental implant is a metal post that is placed surgically into the jaw bone to support a tooth), orthodontic treatment (where malpositioned teeth are repositioned to give a better appearance and improved function) and minor oral surgery. They are supported by a hygiene therapist, seven dental nurses, a practice manager, a business development manager and a receptionist.

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.

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 also spoke with patients on the day of our inspection. We received feedback from 12 patients. These provided a very positive view of the services the practice provides. Patients commented on the high quality of care, their confidence in the staff, the relaxed atmosphere, the cleanliness of the practice and the efficiency and professionalism of staff.

Our key findings were:

• Patients commented that they were very happy with their care, staff were caring, efficient and knowledgeable and appointments were flexible.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice appeared very clean and well maintained and infection control standards were in line with national guidance.

• The practice had medicines and most equipment for use in a medical emergency which were in accordance with national guidelines with the exception of oxygen masks not being available for children and glucagon was stored in an unmonitored fridge. However we were advised following our inspection that these issues would be rectified.

• On the whole staff had received training and support appropriate to their roles and were up to date with their continued professional development (CPD). However we were not able to see records relating to all staff on the day of our inspection.

• Staff reported incidents and these were investigated and learning implemented to improve safety.

• Governance arrangements were in place for the smooth running of the service.

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

• Review the protocols and procedures to embed a system of monitoring to ensure staff are up to date with their mandatory training and their Continuing Professional Development.
• 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 refrigerator temperature is monitored and recorded.
• Review its audit protocols to ensure audits are practitioner specific where appropriate to identify specific areas for improvement.

• Review the practice’s infection control procedures and protocols giving due regard to 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 practice's recruitment arrangements to ensure they are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place where relevant and the required specified information in respect of persons employed by the practice is held.

We used a number of different methods to help us reach a judgement on this service. These included talking with three patients who used the service, two members of the staff team, one dentist who was also the registered provider and three members of the management team.

We also looked at records. These included treatment plans, records of meetings and information about how the service operated. We looked at information from surveys and audits undertaken by the provider to assess the quality of the service.

We found that the Practice was well managed, clean and organised in a way which kept patients at the centre of the way they operated.

Patients told us they received the treatment they wanted in an efficient and organised way. They said they were involved in decision making about their treatment and were able to express their views about the service provided.

We spoke to one patient together with their relative who told us, “I feel like they do an excellent job. I have had ongoing treatment and the results have been good.” Another patient said, “I know the dentist well and he always talks about the options before he does anything.”

Patients said they always found the environment to be clean and tidy. They told us staff wore the right protective equipment when treating them, such as uniforms, gloves and masks. We saw that the practice had a robust infection control policy and that staff were proactive in implementing it.