We carried out an announced comprehensive inspection on 08 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

Walton Dental Practice is a general dental practice in Walton-on-the-Hill, Surrey, offering NHS and private dental treatment to adults and children. The premises consist of one dental treatment room,. a decontamination room, a reception and waiting area and a staff room. There is also one other treatment room but this is currently occupied by non-dental services.

The practice staffing consisted of a principal dentist (who was also the owner and provider), three dental nurses and a receptionist. The dental nurses and receptionist worked various part-time hours to accommodate flexible working depending on the need.

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. Patients felt they received very good care from the dentist and the team were kind and caring.

Our key findings were:

• 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 dentists regularly assessed each patient’s gum health and dentists took X-rays at appropriate intervals.
• The practice kept up to date with current guidelines when considering the care and treatment 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.
• 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.
• There was an effective system in place to act on feedback received from patients and staff.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA).
• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK).
• Review the current guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance giving due regard to the requirement for a legionella risk assessment
• Review the practice's recruitment policy and procedures to ensure staff complete the necessary checks for Fit and Proper Persons employed.

People we spoke with were very happy with the service. One person told us “They have a fantastic approach to people here; I feel like I am their only client as I am never rushed.” Another person said “They see me on time, I never have to wait and they are very flexible with appointment times.” A third person told us “I always get good service here. If I need the dentist he is always there for me, even out of hours.”

People told us that they felt respected by staff, and were able to take part in decisions about their treatment.

Medical histories were reviewed with each person before they received treatment. Treatment plans contained details of the treatment proposed. People told us they were able to get treatment when they needed it, for example in the case of emergencies.

The people we spoke with told us they felt safe with the staff.

We saw that the surgery was clean, and well maintained. People we spoke with were satisfied with the standard of cleanliness in the surgery.

We saw that records of qualifications, criminal record checks and professional registrations were up to date.

All the people we spoke with were happy with the service, and had never felt the need to make a complaint.