We carried out an announced comprehensive inspection on 9 December 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

Claradent located in Hounslow London, provides NHS and private dental treatment to patients of all ages.

Practice staffing consists of the two principal dentists, three dentists, one hygienist, four dental nurses, two trainee dental nurses, two receptionists and a practice manager.

One of the principal dentists 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.

The practice is open Monday Wednesday and Friday 9am to 6pm, Tuesday and Thursday 9am to 7pm and Saturday 9am to 5pm

The practice facilities include three treatment rooms, a reception and waiting area, decontamination room, office and staff room/kitchen.

56 patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received from the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• Equipment, such as the autoclaves, fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• 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).
• The practice sought feedback from patients about the services they provided and acted on this to improve its services.

• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical audits were carried out to monitor the quality of services.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.

We identified that the practice was dedicating extra time and resources and using innovative methods to promote, especially amongst young children, the importance of a well-balanced diet, reduced sugar intake, correct brushing technique and the application of fluoride. The dentists told us that they had noticed these measures were making a positive impact on their patients’ oral health.

We believe this to be notable practice and worth sharing.

During the inspection we talked with four people using the service and six members of staff to find out about the service.

People received all the necessary information about the problems they presented with, the treatment options and the costs so they had the necessary information to make decisions about the treatment they wanted. A treatment plan was given to all people for them to sign to show they understood and agreed to their treatment. The practice promoted good oral hygiene and there was a range leaflets to inform people about dental conditions and how to prevent these.

Dentists ensured that they had a full medical history and information about people’s medicines before treating them. The practice kept emergency medicines and some equipment to ensure people received appropriate care if there was an emergency.

Overall staff were vetted before they started work in the practice to protect people against risks that can arise if staff were not recruited appropriately. The manager made arrangements for staff to receive the necessary training and supervision to ensure they were competent and skilled to work in the service.

The practice had appropriate quality assurance systems. There was an annual satisfaction survey to get information about people’s views of the service and to identify any areas for improvement. There were also various audits to monitor the quality of the service to ensure people received safe and appropriate care.