We carried out an announced comprehensive inspection on 31 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

Oasis Dental Care St Albans is located in the county of Hertfordshire and provides mainly private dental treatment to both adults and children. The premises are on the ground floor and consist of four treatment rooms, a reception area and a dedicated decontamination room. The practice is open Monday to Thursday 8:00am – 7:00pm and Friday 8:00am - 4:00pm.

The staff consists of five associate dentists, two dental hygienists, one dental nurse, one dental nurse who is also the practice coordinator, one dental nurse who is also the receptionist, one trainee dental nurse and the practice manager.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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.

We reviewed four CQC 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 two CQC inspectors.

Our key findings were:

• There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.

• Staff were aware of their responsibilities under the Duty of Candour.

• 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).

• 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 air compressor, 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.

• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.

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

• Review its audit protocols to document learning points that are shared with all relevant staffand ensure that the resulting improvements can be demonstrated as part of the audit process.

• Review the protocols and procedures to ensure staff are up to date with their mandatory training and their Continuing Professional Development.

We noted that during our follow up visit to this practice that the provider had implemented some of the policies, practices and procedures that were not in place when we last visited.

People using the service had been given detailed information about the treatment options available to them and the costs involved.

We observed that people's privacy and dignity was respected during their discussions with the reception staff and when they went into the surgery for treatment. Staff were able to tell us how they made special arrangements to assist individuals with specific sensory needs or responded to people’s preferences, regarding how their treatment was carried out.

We identified that there were effective systems in place to reduce the risk and spread of infection.

We noted that dentists and practice staff had current registrations with the General Dental Council and had attended courses to keep themselves up to date with current guidance that ensured safe practice.

We observed that the practice was designed to be accessible to people with mobility problems and wheelchair users. A disabled toilet had been provided.

People told us that they were generally happy with the standard of care they received at this practice. They said their dignity and privacy was respected at all times. People who used this service told us that they were always given an opportunity to ask questions about their treatment. This was done in the privacy of the treatment rooms.

A new manager had recently been appointed due to there being some gaps and concerns previously. This was because policies and procedures had either not been put in place or had not been fully implemented. This meant that people were not receiving a consistent standard of care and were at risk of receiving care that was inappropriate or unsafe. Two people that we spoke to told us they had been attending the surgery for many years. They said they can usually get an appointment fairly quickly, and they found this reassuring.

Overall we found that the provider was operating effective systems to ensure patients received appropriate care and treatment in a clean environment. We found that services were provided by staff who were appropriately supported in relation to their responsibilities. Minor issues that we identified were discussed with the provider during our visit.