We carried out an announced comprehensive inspection on 07 June 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

211 Dental is located in the London Borough of Brent and provides NHS and private dental treatment to both adults and children. The premises are on the ground floor and consists of two treatment rooms, a reception area and a dedicated decontamination room. The practice is open Monday 9:00am – 6:15pm, Tuesday and Thursday 9:00am – 5:45pm, Wednesday and Friday 9:00am – 5:00pm.

The staff consists of the principal dentist, three associate dentists, one trainee dental nurse, four dental nurses, one of whom is the receptionist.

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 11 CQC comment cards, the practice patient satisfaction survey and the NHS Friends and Family test comment cards. Patients 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:

• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• 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.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection
• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients indicated that they found the team to be efficient, professional, caring and reassuring.
• Patients had good access to appointments, including emergency appointments, which were available on the same day
• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.
• 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 areas where the provider could make improvements and should:

• There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.
• 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) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society
• Review the practice’s protocol for staffs training in safeguarding ensuring it covers both children and adults and all staff are trained to an appropriate level for their role and aware of their responsibilities.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.
• Review the storage of records related to people employed and the management of regulated activities giving due regard to current legislation and guidance.
• Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal reference taken and ensuring recruitment checks, including references, are suitably obtained and recorded.

Patients of the dental practice indicated that they were well treated and staff were respectful towards them. They informed us that they had been provided with information regarding the service. A leaflet with Information regarding the services was available for patients. The provider provided evidence that the views of patients had been sought and the practice had an action plan to improve services.

Patients expressed confidence in their dentists and other staff who attended to them. Treatment options had been explained and treatment had been given with their agreement and written consent. Detailed assessments and treatment plans had been prepared. Audits of treatment provided and waiting times had been carried out. Patients informed us that they were satisfied with the treatment provided. Staff were aware of the arrangements for safeguarding patients.

The premises were clean and well maintained. There were arrangements for infection control checks and tasks. Staff were knowledgeable regarding infection control and decontamination procedures for equipment and instruments used. There was documented evidence that equipment used had been maintained and inspected by specialist contractors. Regular checks had also been carried out by practice staff.