We carried out an announced comprehensive inspection on 1 July 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.

Queens Dental Practice Dental Clinic is a general dental practice in Buckhurst Hill, Essex offering private dental treatment to adults and NHS treatment to children. The premises are located on the ground floor and consist of two dental treatment rooms, a reception and waiting area and a designated decontamination room.

The staff at the practice consist of a principal dentist, a practice manager, a dental hygienist and a dental nurse.

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 an induction 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.

• 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 and the X-ray equipment.

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

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

• The practice had a holistic approach to healthcare and placed an emphasis on the promotion of oral and general health and the prevention of dental disease. Appropriate information and advice was available according to patients’ individual needs.

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

• Patients received comprehensive assessments of their oral health needs. They were given clear explanations about their proposed treatment, and its 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 kind, caring, very welcoming and worked well as a team.

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

• We reviewed 40 Care Quality Commission (CQC) comment cards that had been completed by patients prior to our inspection. We also spoke with four patients on the day of our visit. Common themes were patients felt they received excellent care from staff who were knowledgeable, friendly, professional and put them at their ease.

We previously inspected The Queens Dental Practice on 02 October 2013. At that inspection, we found minor concerns with this standard. This was because the provider had not audited their decontamination procedures every six months in accordance with the Department of Health guidelines (HTM 01-05). Further, the provider did not carry out regular audits to monitor the service.

At our inspection of 03 July 2014, we found that this was no longer the case as the provider audited their decontamination procedures every six months. The provider had effective systems in place to identify, assess and manage the risks to people who used the service.

We spoke with two people who used the service during our inspection. They told us they were given good information about any planned treatment options and costs before it was carried out. We saw that this was evidenced in the four patient records that we looked at.

People told us they were satisfied with the care and treatment they received at the service. One person told us, "The treatment is very good. I hadn't been to a dentist for years. I told the dentist that I was very nervous and [they] were very good. [The dentist] explains everything really well so you feel confident and comfortable. You get good information and know what's happening and you can see everything on the screen."

People were treated in a clean and hygienic environment.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. One person we spoke with described the staff as "... lovely". Another person commented, "They are very professional staff".

We found that systems to identify, assess, and manage risks, and to demonstrate the quality of the service provided were not effectively established.