We carried out an announced comprehensive inspection on 22 February 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

Banstead Dental Care is located in Banstead, Surrey. The premises are situated at the beginning of the High Street and has a private car park on the drive for staff and patients. There are four treatment rooms, a reception area and a waiting area on the ground floor of the premises.

The practice provides private services to adults and children. There is as a limited NHS service for children that are already registered with the practice. The practice offers a range of dental services including dental hygienists, routine examinations and treatment, veneers and crowns and bridges. Visiting dentists provide conscious sedation, complex oral extractions, implant services and root canal treatment.

The practice staffing consisted of two principal dentists (who were also the owners), one general dentist, four visiting dentists, three dental hygienists, five dental nurses and five receptionists. The dental team worked various part-time hours depending on the need. Two of the visiting dentists providing specialist services included dental sedation services.

The practice opening hours are on Monday to Friday from 8.30am to 5.00pm and Saturday from 9.00am to 1.00pm.

One of the principal dentists 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.

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

Before the inspection we sent Care Quality Commission (CQC) comments cards to the practice for patients to complete to tell us about their experience of the practice. We collected 29 completed cards. Twenty-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 reported incidents and kept records of these however the practice were not always using 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.

• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• 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 and audits were effective in improving the quality and safety of the services.

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

• Review its incident reporting systems and follow through learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the process.

We spoke with patients who told us they were happy with the treatment they had received at the service. Comments included "My latest treatment has been exquisite" and "They treat my whole family and are very good with all of us".

We looked at the electronic and paper records for patients and saw that they visited the practice regularly, consented to their treatment and that their medical history had been updated at each visit. This meant that patients had been treated safely and that the practice had ensured that patients' dental health was maintained.

We spoke with two members of staff who had been able to identify the different types and signs of abuse for vulnerable adults and children. The staff were able to explain the correct safeguarding reporting procedures to follow should they have any concerns.

We found that the practice had robust systems in place to monitor the quality of the service and good infection control procedures were followed in order to minimise the risk of cross contamination.