We carried out an announced comprehensive inspection on 6 September 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 Village Dental Health Centre is a dental practice providing private treatment for both adults and children. The practice is based in a converted commercial property in Gerrard’s Cross, a town situated in south Buckinghamshire.

The practice has three dental treatment rooms. One of which is based on the ground floor and a separate decontamination room used for cleaning, sterilising and packing dental instruments. The street level area of the practice is accessible to wheelchair users, prams and patients with limited mobility.

The practice’s opening hours are between 12pm and 7pm on Monday and Thursday, 9am and 1pm on Tuesday, 9am and 5pm on Wednesday and 9am and 12pm on Friday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. If patients called the practice when it is closed, an answerphone message gives the telephone number patients should ring depending on their symptoms.

The provider, Mr Colin Conway, shares the practice facilities with another dentist who is separately registered with Care Quality Commission (CQC). Facilities are shared and patients can register with either of the dentists. Three dental nurses are employed jointly by both dentists.

Mr Colin Conway is registered as an individual and is legally responsible for making sure that the practice meets the requirements relating to safety and quality of care, as specified in the regulations associated with the Health and Social Care Act 2008

We obtained the views of two patients on the day of our inspection.

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 practice owner.
• 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 robust and the practice generally followed published guidance.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
• The dentist 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 well supported by the practice owner and was committed to providing a quality service to their patients.
• Information from eight completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

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

• Provide an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections’ and related guidance.
• Review the arrangements for auditing the quality of infection prevention control procedures in accordance with that suggested by the Infection Prevention Society.
• Consider the introduction of the weekly protein test for the ultrasonic cleaning bath.
• Consider the provision of a secure container for clinical waste in the basement prior to collection by the waste contractor.
• Consider securing the decontamination room.
• Set up a system for receiving national patient safety alerts such as those issued by the Medicines and Healthcare Regulatory Agency (MHRA).
• Review the availability of a hearing loop for patients who are hearing aid users.
• Arrange basic life support update training for all staff.
• Review the range of products used in the practice so that the control of substances hazardous to health file contains data sheets of all the products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations.
• Review the current range of policy documents that form part of the practice’s clinical governance system to include a business continuity plan and consent policy.
• Consider formalising the appraisal process by the use of formal appraisal records detailing aims and objectives and learning outcomes.
• Consider introducing a staff recruitment policy and induction record to include fire safety and employee signature section.
• Review the staff training programme to include fire safety and radiography.

People told us that they were very satisfied with the care and treatment provided by the dentist and staff. They said that staff respected and upheld their dignity. For example, staff discussed and explained the treatment and options available.

People said that the dentist and staff promoted their privacy. For example, treatment and consultations were provided behind closed doors.

People told us that they were enabled to ask questions if they were unsure of information provided to them. They said that they were not expected to make a decision about their care and treatment straight away.

People said that questions asked about their care and treatment were answered satisfactorily. People told us that they were made aware of how much the treatment would cost.

People said that the surgery was always clean and spotless.