We carried out an announced comprehensive inspection on 24 September 2015 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 practice is one of two dental practices owned by the principal dentist with both registered separately with the Care Quality Commission (CQC). The practice was founded in June 2010 by the principal dentist. The premises consist of two treatment rooms and one dedicated decontamination room. There are public and staff toilet facilities, a waiting room and separate reception area, an administrative office and staff kitchen.

The practice provides private dental services and treats both adults and children. There are approximately 1,300 registered patients. The practice offers a range of dental services including veneers, crowns and bridges, oral hygiene and fissure sealants.

The service is provided by two dentists one of whom is the principal, two dental hygiene therapists, a dental nurse and a receptionist. A trainee dental nurse has recently been employed by the practice who is due to replace the current dental nurse who is taking on an administration role from 1October 2015. The practice is open from 9:00 am to 6.00 Monday, Tuesday, Wednesday and Friday; from 9.00 am to 7.00 pm on Thursday and from 9.00 am to 2.00 pm on Saturday. The practice is closed for lunch between 1.00 pm and 2.00 pm Monday to Friday.

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.

We carried out an announced, comprehensive inspection on 24 September 2015. The inspection took place over one day and was carried out by a CQC inspector and a dentist specialist advisor.

We received 28 CQC comment cards completed by patients who all commented positively about the staff and the care they received from the practice. We reviewed patient feedback gathered by the practice over the last 12 months.

Our key findings were:

• The practice had systems to assess and manage risks to patients and staff, including for infection prevention and control, health and safety and the management of medical emergencies. The practice however did not have an automated external defibrillator (AED)

• Equipment, such as the autoclave (steriliser), fire extinguishers and oxygen cylinder were checked for effectiveness and were regularly serviced.
• Dental care records were well maintained and patients were referred for specialist treatment in a timely way.
• Patients said they felt the practice offered an excellent service and that the whole dental team were professional, caring, respectful and friendly.
• The practice had a clear vision for the services it provided and staff told us they were well supported by the management team.
• There was evidence that the practice audited many areas of their practice as part of a system of improvement and learning.

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

Review staff awareness of Gillick competency and the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities as it relates to their role.

Monitor and record the fridge temperature to ensure that medicines were being stored in line with the manufacturer’s guidance.

Review current protocols to ensure personnel records for all staff are appropriately maintained.

During the inspection we spoke with three members of staff and two people who use the service on the phone. People said they were very happy with the care and treatment they received from the practice. One person said “I have no hesitation in recommending the practice to friends and relatives”. Another told us, “I am not going anywhere else except to this practice for dental treatment”.

All people who spoke with us said the dentists explained the treatment options to them and the costs so they had all the necessary information to make an informed decision about the treatment they wanted. They told us they had always been treated with respect and dignity. They said they did not have to wait a long time for appointments and that they were seen mostly on time.

The practice was clean and well maintained. There were appropriate arrangements in place for the decontamination and sterilisation of instruments. Systems were also in place for the monitoring and assessment of infection prevention and control to minimise the risks and spread of infection.

The provider had a number of processes to monitor and assess the quality of the service provided. This included satisfaction surveys and a range of audits. Where required action plans were drawn up to address areas that required improvements.