We carried out an announced comprehensive inspection on 28 January 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.

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

1-5 Orchard Road is located in the London Borough of Barking and Dagenham and provides NHS and private dental treatment to both adults and children. The premises are on the ground floor and consist of four surgeries, a reception area and a dedicated decontamination room. The premises are wheelchair accessible and have facilities for wheelchair users. The practice is open Monday to Friday 8:30am – 5:00pm.

The staff consists of three associate dentists, three dental nurses, two trainee dental nurses who also undertook the role of receptionists and a practice manager.

The dental executive is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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 received 21 Care Quality Commission (CQC) comment cards completed by patients. Patients who completed the comment cards were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

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

Our key findings were:

• Patients were involved in their care and treatment planning so they could make informed decisions.

• There were effective processes in place to reduce and minimise the risk and spread of infection.

• Equipment to manage medical emergencies such as oxygen was readily available. Staff knew where the equipment was stored.

• There were systems in place to check equipment including the autoclave, oxygen cylinder and the X-ray equipment had been serviced regularly.

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

• 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.

• At our visit we observed staff were kind, caring and professional.

• There was a lack of effective processes for acknowledging, recording, investigating and responding to complaints made by patients.

• Suitable checks had not been undertaken before employing staff.

• There was a lack of an effective process to ensure staff were working towards completing the required number of continuing professional development hours to maintain their professional development in line with requirements set by the General Dental Council.
• The provider did not have efffective systems to monitor and improve quality, as was evident from lack of routine audits in key areas, such as radiography. Audits that had been undertaken lacked information and actions identified were not always carried out.

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

• Establish an effective process for acknowledging, recording, investigating and responding to complaints made by patients.

• Ensure audits of various aspects of the service, such as radiography, are undertaken at regular intervals to help improve the quality of service. The practice should also check, that where appropriate the audits have documented learning points and the resulting improvements can be demonstrated.

• Review the procedures and protocols to comply with relevant Patient Safety Alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS).

People told us they were treated with dignity and that their privacy was respected. Comments included "the girls (staff) are very good and friendly" and "they are very discreet." We saw that treatments and fees were explained clearly, and that people signed to show consent for these. The lay out of the building provided the opportunity for discussions to be held in private. People told us they were happy with the care and treatment provided. One said "I've been coming here for 25 years, they are really good." We found treatment plans were in place, although these did not identify which dentist provided the treatment.

The service had appropriate safeguarding procedures in place, and people told us they felt safe when receiving treatment. Staff had undertaken training in safeguarding children and vulnerable adults. The service had a complaints procedure, and we saw that complaints received had been investigated and responded to appropriately.

People we spoke with told us they found the premises to be clean, and that staff wore protective clothing. One person said "it's always been clean." We found the service to be visibly clean on the day of our visit. Procedures were in place to clean and sterilise dental equipment used.