We carried out an announced comprehensive inspection on 5th 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

Tudor House Dental Practice a mixed NHS and private general dental practice in Ashtead, Surrey. The premises are located above an estate agency on a high street next to rows of retail shops and businesses. The premises are not suitable for patients using a wheelchair as there are stairs leading to the practice. There are two dental treatment rooms, a reception and waiting area and an office that can also be used as a staff room.

The practice staffing consisted of a principal dentist who was also the provider, an associate dentist, a practice manager, two dental nurses, a receptionist and two dental hygienists.

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 reviewed 23 Care Quality Commission (CQC) comment cards that had been completed by patients in the two weeks prior to our inspection. Common themes were patients felt they received excellent care from friendly staff who were professional, caring and understanding. They also commented that the dentist had a nice manner that made nervous patients feel relaxed.

Our key findings were:

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

• 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.
• 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.
• Patients received 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 and very welcoming.

We spoke with eight patients who used the service and three members of staff. One patient told us that the staff were “very communicative.” Another patient said “I have always been happy here.” One member of staff that we spoke with told us that they were very happy working at the practice and added “I just really love my job.”

We had positive feedback from all of the patients that we spoke with. One patient told us “we always discuss situations and come to a mutual consensus about treatment.”

The patients we spoke with said that they were always asked for consent before treatment commenced.

We found that the practice had the necessary arrangements in place to ensure that they were meeting minimum requirements in terms of cleanliness and infection control.

We saw that the practice had systems in place to record any complaints, comments or suggestions.