We carried out an announced comprehensive inspection on 18 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.

The Hertfordshire Centre for Dentistry is a dental practice in central Harpenden, Hertfordshire that offers general private dental treatment to adults and children as well as specialist restorative treatment. The practice also employs visiting dental specialists to provide a range of specialist services including periodontics (specialism in prevention and treatment of the inflammatory disease affecting the supporting structures of the teeth), orthodontics, endodontics (root canal therapy) and prosthodontics (specialism in replacement or reconstruction of lost or damaged teeth).

The premises are located over two floors and consist of six treatment rooms and a reception/waiting area. There is also a separate decontamination room as well as a designated decontamination area in one of the treatment rooms.

The staff at the practice consist of two practice managers, a principal dentist, ten associate dentists, five dental nurses, a trainee dental nurse, a dental hygienist/therapist, a dental hygienist and a receptionist. Of the ten associate dentists, four are registered with the General Dental Council as specialists in areas including endodontics, periodontics, orthodontics, prosthodontics and restorative dentistry. The principal dentist is the registered manager.

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.

Our key findings were:

• There was a comprehensive induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• The practice had a system in place to accept referrals from other practices for services including dental implants, treatment of periodontal disease and endodontic treatment.

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers, oxygen cylinder and the X-ray equipment.

• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

• Dentists received tutorials from the endodontic specialist and were able to shadow other dental specialists on some occasions (with the patient’s permission) in order to learn and develop.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were caring and professional.

• We received feedback from 47 patients. Common themes were patients felt they received excellent service in a safe and hygienic environment from staff who were caring, reassuring, friendly and professional.

• There was an effective system in place to act on feedback received from patients and staff.

• There were systems in place to assess, monitor and improve the quality of service provided.

• The practice had promoted good oral health and developed links with the local community by sponsoring a local rugby team and participating in local community and charity events.

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

• Review the arrangements for the stock control of antibiotic and pain control medicines dispensed by the practice.

• Review the fire safety signage in the practice to ensure staff and patents are clear about escape routes and where to assemble in the event of a fire.

• Review infection control procedures to ensure there are clearly defined clean and dirty zones in each treatment room.