We carried out an announced comprehensive inspection on 11 December 2015 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

The practice provided NHS and private dental treatment to patients of all ages in Enfield and surrounding areas. The premises are situated on the ground floor of a residential style building. The practice was taken over in October 2015 by the current providers. The services provided include preventative advice and treatment and routine restorative dental care.

The practice is managed by two dentist partners who are supported by an associate dentist, one dental nurse/receptionist and one trainee dental nurse.

One of the principal dentists has applied to be 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 consists of one treatment room, another room which is the reception/office, a large waiting area for patients, a separate decontamination room and a staff room.

During our inspection we spoke with two patients and reviewed six comments cards, which patients had completed in the two weeks before our visit. All patients commented positively about the care and treatment they had received and the friendly, efficient and professional staff. A number of patients commented on the sympathetic, understanding dentists who had helped them overcome their fears.

The practice is open on Mondays to Fridays from 9am to 5pm and appointments are available during these times.

Eight patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received and about the service. Patients told us that they were happy with the dental treatment and advice they had received. They said that they could get appointments at times that suited them, including same day appointments for urgent dental treatments. Patients told us that staff were professional, kind and caring. They told us that dentists, dental nurses and receptionist were always kind, welcoming and helpful. Patients said that the dentists explained treatments in a way that they could understand, listened to them and answered any questions they had about their care and treatment. Patients who completed comment cards said that they had recommended the dental practice to their friends and families.

Our key findings were:

• The practice investigated significant and safety events and cascaded learning to staff. These events were analysed and monitored to help improve patient safety.
• There were systems in place to reduce the risk and spread of infection. We found the treatment room and equipment appeared clean. Dental instruments were cleaned and sterilised in line with current guidance. Infection control audits were carried out to test the effectiveness of cleaning and infection control practices.
• There were systems in place to ensure that all equipment, including the suction compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.
• 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.
• Patients’ care and treatment was planned and delivered in line with current legislation and evidence based guidelines such as that from the National Institute for Health and Care Excellence (NICE).
• The practice ensured staff were trained and that they maintained the necessary skills and competence to support the needs of patients.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to handle medical emergencies and appropriate medicines and life-saving equipment were readily available.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients. The principal dentist told us that no complaints had been received about the service.
• The practice was well-led and staff felt valued, involved and worked as a team. Staff meetings were routinely held to help share information and learning. Both dentist partners were very ‘hands on’ and carried out regular audits and took lead roles in the management and day to day running of the practice.
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical and non-clinical audits were carried out to monitor the quality of services.
• The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.