During and after our visit we spoke with five patients about the care and treatment they had received at the practice. Everybody was very complimentary about the care they received.

Relevant staff had received training for the decontamination procedures which they were expected to perform, including the correct use of equipment. The dentist had the day-to-day responsibility for management of decontamination equipment and processes. There were appropriate systems in place to assess the risk of and to prevent, detect and control the spread of infection.

Staff, patients and people who used the surgery were provided with information on the risks to their health and safety and what to do in the event of an emergency, for example fire. These measures were displayed throughout the practice. Emergency evacuation procedures were in place and records showed they were practiced annually.

Patients told us that they always received a "very good service" and we were told by one patient that " I can't think of anything more the practice could do". The dentist was responsible for assessing and monitoring the quality of the service delivery and he did this effectively.

We carried out an announced comprehensive inspection on 31st January 2017 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

Robert Herron Dental is a dental practice providing mainly private treatment for adults and a small NHS contract for exempt adults and children. The practice is based in a converted commercial property in Liphook, a village situated in south Hampshire.

The practice has one dental treatment room on the first floor and a separate decontamination room.

The practice employs one dentist, who is the practice owner and Registered Manager, one dental nurse and two reception staff.

The practice’s opening hours are between 08:30 and 17:00 Monday to Thursday and between 08:30 and 13:00 on Friday. The practice is closed each weekday between 13:00 and 14:00

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service or direct access to an emergency mobile phone number.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person. 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.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Clinical and business leadership was provided by the principal dentist
• Staff had been trained to handle emergencies and appropriate emergency medicines and medical oxygen and other breathing aids were available in accordance with current guidelines. We did note that the practice did not have an automated external defibrillator (AED) a portable electronic device that analyses life threatening irregularities of the heart and is able to deliver an electrical shock to attempt to restore a normal heart rhythm.
• The practice appeared clean and well maintained.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Infection control procedures were effective and the practice followed published guidance.
• The practice had a process in place for safeguarding adults and children living in vulnerable circumstances.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access both routine and urgent treatment when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the Principal Dentist.
• Staff we spoke with felt well supported by the Principal Dentist and were committed to providing a quality service to their patients.
• Information from 32 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

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

• Provide an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance is prepared.
• Review the availability of hearing loops for patients who wear hearing aids.
• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• 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).
• Review the suite of practice policies ensuring that policies are updated on a more regular basis.
• Reintroduce a system of patient satisfaction surveys to capture patient feedback about the quality of services provided by the practice.
• Risk assess the lack of an automated external defibrillator (AED) and consider purchasing one.