We carried out an announced comprehensive inspection on 3 March 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 Woodcote Dental Practice is located in the London Borough of Sutton. The premises are situated on the ground floor beneath a block of flats. There are two treatment rooms, an autoclave room, waiting room, administrative office, and a patient toilet.

The practice provides private services to adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers and crowns and bridges.

The staff structure of the practice consists of a principal dentist, an hygienist, two dental nurses and a receptionist.

The practice opening hours are from Monday to Friday from 9.00am to 5.00pm.

The principal dentist is the registered manager. A registered manager is a person who is registered with the CQC 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.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Nine people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

• There were effective systems in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Staff knew how to report incidents and how to record details of these so that the practice could use this information for shared learning.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced. However, we found that the oxygen cylinder for use during medical emergencies was out of date and needed replacing.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• Staff were working towards completing continuing professional development (CPD) standards set by the General Dental Council (GDC). However, improvements could be made to ensure that all staff were up to date with training in responding to medical emergencies and safeguarding vulnerable adults and children.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Governance arrangements were in place for the smooth running of the practice; however the practice had not carried out a recent audit of infection control protocols in line with national guidance.

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

• Review the availability of equipment, and the frequency of staff training, for managing medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review staff training to ensure that all of the staff had undergone relevant training, to an appropriate level, in the safeguarding of children and vulnerable adults.
• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities.
• Review the practices’ current Legionella risk assessment and implement the required actions giving due regard to 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’
• Review the practice’s audit protocols, such as those for infection control and dental care records, with a view to monitoring and improving the quality of service. The practice should also check that where appropriate, audits have documented learning points, which are shared with all staff, and the resulting improvements can be demonstrated.